WorldWideScience

Sample records for intrauterine head stab

  1. Intrauterine Idiopathic Amputation of the Head of a Porcine Foetus

    DEFF Research Database (Denmark)

    Agerholm, J. S.; Garoussi, M. T.

    2013-01-01

    Contents An anencephalic full-term porcine foetus accompanied by a mummified head was submitted for examination. The neck almost entirely lacked skin and was covered by granulation tissue as were the exposed parts of the spine and spinal cord. The case represents a rare case of intrauterine...... amputation. A definitive cause could not be established because the placenta was not available. The most likely cause is strangulation of the neck. Such strangulation could be due to a defect of the allantoamnion with herniation of the foetal head or entanglement by amniotic constriction bands....

  2. Primary stabbing headache.

    Science.gov (United States)

    Pareja, Juan A; Sjaastad, Ottar

    2010-01-01

    Primary stabbing headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vågå study). Attacks are generally characterized by moderate to severe, jabbing or stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary stabbing headache may concur, synchronously or independently, with other primary headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Pressure-balanced stab connection

    Energy Technology Data Exchange (ETDEWEB)

    Best, M.J.A.; Jones, R.H.; Hynes, J.H.; Pond, R.J.; Gordon, C.R.

    1987-09-22

    This patent describes an apparatus for sealingly connecting a flow bore of a wellhead to a flowline. It consists of: a stab member including a stab body. The stab body has a stab body bore. One end of the stab body bore exiting from the stab body and being in fluid communication with the flow bore and the other end of the stab body bore exiting from a side of the stab body through a stab body side port; a stab receptacle mounted on the wellhead and having a stab receiving bore for receiving the stab body; the stab receptacle having a receptacle flow bore. One end of the receptacle flow bore being in fluid communication with the stab receiving bore and the other end of the receptacle flow bore exiting the stab receptacle and being in fluid communication with the flowline; means for establishing fluid communication between the stab body side port and the one end of the receptacle flow bore when the stab body is received within the stab receiving bore. It includes means disposed on the stab member for orienting the stab member with respect to the Christmas tree for ensuring the alignment of the stab body side port with the one end of the receptable flow bore when the stab body is received within the stab receiving bore; and first and second sealing means disposed on the stab body above and below the stab body side port, respectively, for sealing engagement with the walls of the stab receiving bore above and below the one end of the receptable flow bore for establishing a non-blow-apart, fluid pressure sealed flow passage between the stab body bore of the stab member and the receptacle flow bore of the stab receptacle when the stab body is landed within the stab receiving bore.

  4. Environmentally Benign Stab Detonators

    Science.gov (United States)

    2006-07-11

    Steve Santor, Mr. Phil Ramsey , and Mr. Octavio Cervantes. Contributors from TACOM-ARDEC include Mr. Gartung Cheng, and Mrs. Neha Mehta...obtain more reproducible stab initiation results led to size sorting of the sheared material. This was performed using a series of Tyler U.S. standard... Tyler Standard 50 Mesh sieve (particle size range is 300 µm to 500 µm) Sample Thickness (um) Bi-layer Period (nm) Coating Min. Stab energy (mJ

  5. Stab resistant body armour

    OpenAIRE

    Horsfall, I

    2000-01-01

    There is now a widely accepted need for stab resistant body armour for the police in the UK. However, very little research has been done on knife resistant systems and the penetration mechanics of sharp projectiles are poorly understood. This thesis explores the general background to knife attack and defence with a particular emphasis on the penetration mechanics of edged weapons. The energy and velocity that can be achieved in stabbing actions has been determined for a numb...

  6. Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

    OpenAIRE

    Souza,Alex Sandro Rolland; Souza,Ariani Impieri de; Faquin,Silvia de Lourdes Loreto; Santos Neto,Orlando Gomes dos; Honorato,Emanuele; Mattos,Alice Góes Liberato; Holanda,Simone Cristina; Figueiroa,José Natal; Schettini,Juliana

    2016-01-01

    Abstract Objectives: to describe altered intrauterine ultrasound, analyze fetal head circumference (HC) growth and neonates' outcomes among presumed cases of congenital Zika syndrome in Brazil. Methods: 30 women were included in the study with suspected history of Zika virus (ZIKV) infection during pregnancy and fetal's brain altered on ultrasound diagnosis. Sociodemographic and obstetric characteristics, prenatal altered ultrasounds, HC and other perinatal outcomes have been described. The...

  7. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A

    2005-12-21

    Many energetic systems can be activated via mechanical means. Percussion primers in small caliber ammunition and stab detonators used in medium caliber ammunition are just two examples. Current medium caliber (20-60mm) munitions are detonated through the use of impact sensitive stab detonators. Stab detonators are very sensitive and must be small, as to meet weight and size limitations. A mix of energetic powders, sensitive to mechanical stimulus, is typically used to ignite such devices. Stab detonators are mechanically activated by forcing a firing pin through the closure disc of the device and into the stab initiating mix. Rapid heating caused by mechanically driven compression and friction of the mixture results in its ignition. The rapid decomposition of these materials generates a pressure/temperature pulse that is sufficient to initiate a transfer charge, which has enough output energy to detonate the main charge. This general type of ignition mix is used in a large variety of primers, igniters, and detonators.[1] Common primer mixes, such as NOL-130, are made up of lead styphnate (basic) 40%, lead azide (dextrinated) 20%, barium nitrate 20%, antimony sulfide 15%, and tetrazene 5%.[1] These materials pose acute and chronic toxicity hazards during mixing of the composition and later in the item life cycle after the item has been field functioned. There is an established need to replace these mixes on toxicity, health, and environmental hazard grounds. This effort attempts to demonstrate that environmentally acceptable energetic solgel coated flash metal multilayer nanocomposites can be used to replace current impact initiated devices (IIDs), which have hazardous and toxic components. Successful completion of this project will result in IIDs that include innocuous compounds, have sufficient output energy for initiation, meet current military specifications, are small, cost competitive, and perform as well as or better than current devices. We expect flash

  8. Intrauterine Devices

    Science.gov (United States)

    S HARE W ITH W OMEN INTRAUTERINE DEVICES INTRAUTERINE DEVICES What is An Intrauterine Device? An intrauterine device (IUD) is anything that is placed inside the uterus (womb) to prevent pregnancy. ...

  9. Altered intrauterine ultrasound, fetal head circumference growth and neonatal outcomes among suspected cases of congenital Zika syndrome in Brazil

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland Souza

    Full Text Available Abstract Objectives: to describe altered intrauterine ultrasound, analyze fetal head circumference (HC growth and neonates' outcomes among presumed cases of congenital Zika syndrome in Brazil. Methods: 30 women were included in the study with suspected history of Zika virus (ZIKV infection during pregnancy and fetal's brain altered on ultrasound diagnosis. Sociodemographic and obstetric characteristics, prenatal altered ultrasounds, HC and other perinatal outcomes have been described. The relation between HC and gestational age was analyzed by using random regression effects based on polynomials fractions. The Z test was calculated to determine an instant variant mean rate of the HC for each gestational age. Results: the mean gestational age of the ultrasound diagnosis was 33.3 + 4.7 weeks and HC at birth was 28.9 + 1.6 cm. The main altered brain ultrasound was microcephaly (96.7%. The analysis of the fetal head circumference showed an estimated increase of the average HC, as to gestational age, it did not occur in a linear form. The instant HC variation rate increased according to gestational age (p<0,001. Conclusions: Fetal's main morphological alteration was microcephaly, observing an increase in the head circumference according to gestational age in a non-linear form and the variation decreased with gestational age.

  10. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  11. Textile sensors for stab and cut detection

    Science.gov (United States)

    Graßmann, C.; Obermann, M.; Lempa, E.; Bache, T.; Siegel, P. K.; Freyer, T.; Paschko, S.; Beyer, T.; Kirsche, M.; Schwarz-Pfeiffer, A.

    2017-10-01

    Manufacturers are aiming for more flexible and lightweight protective clothing to increase wearing comfort. A cardigan with a knitted stab-resistant inlay and an alarm system is presented. The stab-resistant inlay is based on a multilayer ultra-high molecular weight poly ethylene (UHMW-PE) fabric. Stab resistance was evaluated according to the standard of the Association of Test Laboratories for Bullet, Stab or Pike Resistant Materials and Construction Standard (VPAM 2011). Furthermore sensors for the detection of cuts and pressure were integrated. Both sensors can trigger alarms if the wearer is attacked. Normal pressure occurring through leaning on a wall or sitting is filtered out and does not trigger an alarm.

  12. The imaging of stab injuries

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Coert S. de; Africa, Mogoeemang; Gebremariam, Fekade A.; Rensburg, J. Janse van; Otto, Susan F.; Potgieter, Henrik F. (Dept. of Diagnostic Radiology, Faculty of Health Sciences, Univ. of the Free State and Academic Health Complex, Free State Province Dept. of Health, Bloemfontein (South Africa)), e-mail: devriesc.md@ufs.ac.za

    2010-01-15

    In the trauma unit of the Bloemfontein Academic Complex, the total number of stab wounds seen represents approximately 70.5% of penetrating injuries, which is 6.4% of 5004 trauma cases seen in a period of 1 year. The other cases are gunshot wounds and pedestrian or motor vehicle accidents. Specific guidelines and protocols are followed for penetrating trauma management. All imaging modalities are utilized, with chest radiography the mainstay of thoracic imaging in patients having sustained sharp penetrating chest injuries. Computed tomography (CT) is being used more frequently as the primary imaging modality in the evaluation of hemodynamically stable patients with penetrating injuries. The improved speed of data acquisition and superior image reconstruction of multidetector CT (MDCT) has further driven this change in imaging approach. Although digital subtraction angiography (DSA) has been the reference standard for the diagnosis of traumatic vascular injuries, it is giving way to faster, less invasive, and less personnel-intensive imaging techniques, e.g., MDCT angiography. Given the fact that we work in an academic environment and that we have a dedicated interventional unit, arteriography is still frequently performed and still has its place as the 'gold standard' in the diagnosis of vascular injuries. Penetrating chest injuries suspected of traversing the mediastinum or extending near the posterior mediastinal structures dictate esophageal and tracheal evaluation. Although radiology has a role to play, direct visualization (esophagoscopy, bronchoscopy) remains the most reliable method of excluding injuries to these structures. Transthoracic ultrasound (echocardiography) has become indispensable in helping to evaluate injuries to the heart and the ascending and descending aortas. More recent work has demonstrated that ultrasonography can also be used to detect hemothoraces and pneumothoraces with accuracy

  13. Penetrating Stab Wound of the Right Ventricle

    Directory of Open Access Journals (Sweden)

    Onursal Buğra

    2010-04-01

    Full Text Available 18 years old male patient was admitted to our emergency unit with a penetrating stab wound to the right ventricle. A stab wound to the right ventricle was found to be 3 cm in diameter. The bleeding was controlled by insertion of a Foley catheter and inflation of the balloon. The stab wound had transected distal acute marginal side ofthe right coronary artery. A successful repair was performed with the use of a foley catheter and application of the Medtronic Octopus Tissue Stabilization System. The wound was closed with pledgeted mattress sutures. The distal acute marginal side of the right coronary artery was ligated. In this presentation, the surgical intervention method was reported and followed by a discussion of emergency surgical procedures of the heart.

  14. 76 FR 69764 - Stab-Resistant Body Armor Standard Workshop

    Science.gov (United States)

    2011-11-09

    ... of Justice Programs Stab-Resistant Body Armor Standard Workshop AGENCY: National Institute of Justice... Standards and Technology (NIST) are jointly hosting a workshop focused on the NIJ Stab-resistant Body Armor... the revised NIJ Stab-resistant Body Armor Standard and to receive input, comments, and recommendations...

  15. Holmes Tremor Secondary to a Stabbing Lesion in the Midbrain

    Directory of Open Access Journals (Sweden)

    Rubens Gisbert Cury

    2017-12-01

    Full Text Available Background: The development of Holmes tremor (HT after a direct lesion of the midbrain has rarely been reported in the literature, although several etiologies have been linked with HT, such as stroke, brainstem tumors, multiple sclerosis, head trauma, or infections.Phenomenology Shown: A 31-year-old male, having been stabbed in the right eye, presented with a rest and action tremor in the left upper limb associated with left hemiparesis with corresponding post-contrast volumetric magnetic resonance imaging T1 with sagittal oblique reformation showing the knife trajectory reaching the right midbrain.Educational Value: Despite the rarity of the etiology of HT in the present case, clinicians working with persons with brain injuries should be aware of this type of situation.

  16. 17th STAB/DGLR Symposium

    CERN Document Server

    Heller, Gerd; Kreplin, Hans-Peter; Nitsche, Wolfgang; Peltzer, Inken

    2013-01-01

    This volume contains the contributions to the 17th Symposium of STAB (German Aerospace Aerodynamics Association). STAB includes German scientists and engineers from universities, research establishments and industry doing research and project work in numerical and experimental fluid mechanics and aerodynamics, mainly for aerospace but also for other applications. Many of the contributions collected in this book present results from national and European Community sponsored projects. This volume gives a broad overview of the ongoing work in this field in Germany and spans a wide range of topics: airplane aerodynamics, multidisciplinary optimization and new configurations, hypersonic flows and aerothermodynamics, flow control (drag reduction and laminar flow control), rotorcraft aerodynamics, aeroelasticity and structural dynamics, numerical simulation, experimental simulation and test techniques, aeroacoustics as well as the new fields of biomedical flows, convective flows, aerodynamics and acoustics of high-s...

  17. 18th STAB/DGLR Symposium

    CERN Document Server

    Heller, Gerd; Krämer, Ewald; Kreplin, Hans-Peter; Nitsche, Wolfgang; Rist, Ulrich

    2014-01-01

    This book presents contributions to the 18th biannual symposium of the German Aerospace Aerodynamics Association (STAB). The individual chapters reflect ongoing research conducted by the STAB members in the field of numerical and experimental fluid mechanics and aerodynamics, mainly for (but not limited to) aerospace applications, and cover both nationally and EC-funded projects. By addressing a number of essential research subjects, together with their related physical and mathematics fundamentals, the book provides readers with a comprehensive overview of the current research work in the field, as well as its main challenges and new directions. Current work on e.g. high aspect-ratio and low aspect-ratio wings, bluff bodies, laminar flow control and transition, active flow control, hypersonic flows, aeroelasticity, aeroacoustics and biofluid mechanics is exhaustively discussed here.  .

  18. Intrauterine contraception.

    Science.gov (United States)

    Soonawalla, R P

    1968-01-01

    This article is presented to give an idea as to how far the IUD can fulfill the purpose of population control. For the couple, this intrauterine method is most ideal. The main drawback is the side effect of bleeding, which is the cause of the high drop out rate. The other handicaps are spontaneous expulsion and pregnancy with the IUD in situ. It is also unsuited to nulliparous women. The general practitioner needs to become concerned with the gravity of the problem of overpopulation, and he must encourage his patients into the use of contraceptives. At the moment, the IUD is the method of choice.

  19. Intrauterine devices.

    Science.gov (United States)

    Bilian, Xiao

    2002-04-01

    The aim of this chapter is to review the worldwide use of intrauterine devices (IUDs) for contraception and the long-term contraceptive efficacy and safety of copper-bearing IUDs. The TCu380A and Multiload Cu375 have a very low failure rate (0.2-0.5%) over 10 years. The main concerns of the use of IUDs are risk of pelvic inflammatory diseases and increased menstrual blood loss and irregular bleeding. Factors associated with an increase in risk of pelvic inflammatory diseases are discussed. Preventive measures can be taken with careful screening of eligible IUD users, technical training and adequate service facilities for provision of IUDs. Levonorgestrel-releasing IUDs have the benefit of reducing menstrual blood loss in addition to high contraceptive efficacy. The copper IUD is the most effective method for emergency contraception. It can prevent over 95% of unwanted pregnancies within 5 days of unprotected intercourse. Copyright 2002 Elsevier Science Ltd.

  20. Herpes simplex virus following stab phlebectomy.

    Science.gov (United States)

    Hicks, Caitlin W; Lum, Ying Wei; Heller, Jennifer A

    2017-03-01

    Herpes simplex virus infection following surgery is an unusual postoperative phenomenon. Many mechanisms have been suggested, with the most likely explanation related to latent virus reactivation due to a proinflammatory response in the setting of local trauma. Here, we present a case of herpes simplex virus reactivation in an immunocompetent female following a conventional right lower extremity stab phlebectomy. Salient clinical and physical examination findings are described, and management strategies for herpes simplex virus reactivation are outlined. This is the first known case report of herpes simplex virus reactivation following lower extremity phlebectomy.

  1. Unusual Presentation of Meningitis following Stab Neck | Motsitsi ...

    African Journals Online (AJOL)

    Background: A case report of stab neck presenting at Kalafong Hospital, Pretoria, South Africa with atypical meningitis. The objective was to illustrate the challenge of diagnosing this unusual and late presentation of meningitis. Case Report: A 48 year-old male patient presented to us two days after a stab neck. He was ...

  2. [Gunshot and stab wounds in Germany--epidemiology and outcome: analysis from the TraumaRegister DGU®].

    Science.gov (United States)

    Bieler, D; Franke, A F; Hentsch, S; Paffrath, T; Willms, A; Lefering, R; Kollig, E W

    2014-11-01

    The management of gunshot wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. Penetrating injuries occur with an incidence of 5% in Germany. They are caused by gunshots or more commonly by knives or other objects, for example during accidents. Since even the number of patients who are treated at level 1 trauma centres is limited by the low incidence, the objective of this study was to assess the epidemiology and outcome of gunshot and stab wounds in Germany. Since 2009, the trauma registry of the German Trauma Society (TraumaRegister DGU®) has been used to assess not only whether a trauma was penetrating but also whether it was caused by a gunshot or a stabbing. On the basis of this registry, we identified relevant cases and defined the observation period. Data were taken from the standard documentation forms that participating German hospitals completed between 2009 and 2011. We did not specify exclusion criteria in order to obtain as comprehensive a picture as possible of the trauma entities investigated in this study. As a result of the high incidence of gunshot wounds to the head and the implications of this type of injury for the entire group, a subgroup of patients without head injuries was analysed. From 2009 to 2011, there were 305 patients with gunshot wounds and 871 patients with stab wounds. The high proportion of suicide-related gunshot wounds to the head resulted in a cumulative mortality rate of 39.7%. Stab wounds were associated with a lower mortality rate (6.2%). Every fourth patient with a gunshot or stab wound presented with haemorrhagic shock, which was considerably more frequently seen during the prehospital phase than during the inhospital phase of patient management. Of the patients with gunshot wounds, 26.9% required transfusions. This percentage was three times higher than that for patients with blunt trauma. In Germany, gunshot and stab wounds have a low

  3. Intrauterine devices (IUD)

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007635.htm Intrauterine devices (IUD) To use the sharing features on this page, please enable JavaScript. An intrauterine device (IUD) is a small plastic T-shaped device ...

  4. Early MRI findings in stab wound of the cervical spine: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, A.; Baysal, T.; Sarac, K.; Sigirci, A.; Kutlu, R. [Inonu Universitesi Turgut Ozal Tip Merkezi, Radyoloji Anabilim Dali, Malatya (Turkey)

    2002-01-01

    MR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings. (orig.)

  5. Conservative treatment of abdominal stab wounds with omental protrusion

    DEFF Research Database (Denmark)

    Duus, B R; Damm, P; Jensen, F U

    1987-01-01

    Two cases of abdominal stab wounds with omental protrusion treated conservatively are presented. Omental protrusion in a patient without signs of shock or peritoneal irritation is not an absolute indication for explorative laparotomy.......Two cases of abdominal stab wounds with omental protrusion treated conservatively are presented. Omental protrusion in a patient without signs of shock or peritoneal irritation is not an absolute indication for explorative laparotomy....

  6. Characteristics and rehabilitation for patients with spinal cord stab injury

    Science.gov (United States)

    Wang, Fangyong; Zhang, Junwei; Tang, Hehu; Li, Xiang; Jiang, Shudong; Lv, Zhen; Liu, Shujia; Chen, Shizheng; Liu, Jiesheng; Hong, Yi

    2015-01-01

    [Purpose] The objective of the study was to compare the incidence, diagnosis, treatment, and prognosis of patients with spinal cord stab injury to those with the more common spinal cord contusion injury. [Subjects] Of patients hospitalized in China Rehabilitation Research Center from 1994 to 2014, 40 of those having a spinal cord stab injury and 50 with spinal cord contusion were selected. [Methods] The data of all patients were analyzed retrospectively. The cases were evaluated by collecting admission and discharge ASIA (American Spinal Injury Association) and ADL (activity of daily living) scores. [Results] After a comprehensive rehabilitation program, ASIA and ADL scores of patients having both spinal cord stab injury and spinal cord contusion significantly increase. However, the increases were noted to be higher in patients having a spinal cord stab injury than those having spinal cord contusion. [Conclusion] Comprehensive rehabilitation is effective both for patients having spinal cord stab injury and those with spinal cord contusion injury. However, the prognosis of patients having spinal cord stab injury is better than that of patients with spinal cord contusion. PMID:26834329

  7. The intrauterine device and the intrauterine system.

    Science.gov (United States)

    Stephen Searle, E

    2014-08-01

    Intrauterine contraception is used by about 100 million women worldwide, making it the most popular form of fertility regulation. In UK community contraception clinics, however, long-acting reversible contraception has increased to 28% of users, and intrauterine contraception accounts for only 8% of methods used by women accessing these services. Potential exists to increase uptake of these more effective methods. In this chapter, we review the clinical advantages, disadvantages and cost-effectiveness of intrauterine contraception. We discuss the management of complications along with advice for trainers, and briefly consider issues in developing countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Selective Nonoperative Management of Abdominal Stab Wounds.

    Science.gov (United States)

    Murry, Jason S; Hoang, David M; Ashragian, Sogol; Liou, Doug Z; Barmparas, Galinos; Chung, Rex; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Stab wounds (SW) to the abdomen traditionally require urgent exploration when associated with shock, evisceration, or peritonitis. Hemodynamically stable patients without evisceration may benefit from serial exams even with peritonitis. We compared patients taken directly to the operating room with abdominal SWs (ED-OR) to those admitted for serial exams (ADMIT). We retrospectively reviewed hemodynamically stable patients presenting with any abdominal SW between January 2000 and December 2012. Exclusions included evidence of evisceration, systolic blood pressure ≤110 mm Hg, or blood transfusion. NON-THER was defined as abdominal exploration without identification of intra-abdominal injury requiring repair. Of 142 patients included, 104 were ED-OR and 38 were ADMIT. When ED-OR was compared with ADMIT, abdominal Abbreviated Injury Score was higher (2.4 vs 2.1; P = 0.01) and hospital length of stay was longer (4.8 vs 3.3 days; P = 0.04). Incidence of NON-THER was higher in ED-OR cohort (71% vs 13%; P ≤ 0.001). In a regression model, ED-OR was a predictor of NON-THER (adjusted odds ratio 16.6; P patient from ED-OR expired after complications from NON-THER. There were no deaths in the ADMIT group. For those patients with abdominal SWs who present with systolic blood pressure ≥110 mm Hg, no blood product transfusion in the emergency department and lacking evisceration, admission for serial abdominal exams may be preferred regardless of abdominal exam.

  9. Primary stabbing headache in adults and pediatrics: a review.

    Science.gov (United States)

    Hagler, Suzanne; Ballaban-Gil, Karen; Robbins, Matthew S

    2014-10-01

    Primary stabbing headache (PSH) is an under-recognized primary headache disorder, which often goes undiagnosed. It is mainly characterized by its ultrashort stabbing quality and can be easily overlooked both by patients and providers as it is often not severe enough to interfere significantly with daily life. However, PSH may be severe and require therapy, and it is important for providers to recognize this headache type, both in adult and pediatric populations, as well as to be able to distinguish it from secondary headache disorders. PSH also may be more common than previously thought.

  10. The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries.

    Science.gov (United States)

    Rozenfeld, Michael; Peleg, Kobi; Givon, Adi; Kessel, Boris

    2017-07-01

    When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing. This study was carried out retrospectively using data on 8714 patients with stabbing-related injuries from 19 trauma centers that participated in the Israeli National Trauma Registry (INTR) between January 1st1997 and December 31st 2013. Patients with wounds of upper extremities in addition to torso injuries (UE group) were compared to other patients with torso injuries (TO group) in terms of demographics, injury characteristics and clinical outcome. The compared groups were found to be homogeneous in terms of age and systolic blood pressure; the number of sustained torso injuries was also identical. The UE group comprised a slightly greater percentage of females, however both groups were predominantly male. Patients with upper extremity injuries had a lower proportion of internal organ damage (36% vs. 38.5%) and lower mortality (0.9% vs. 2%). The higher mortality of patients without upper extremity wounds remained significantly different even when adjusted by other epidemiological parameters (OR 2.46, 95% CI 1.33-5.08).The number of sustained upper extremity injuries was positively associated with deeper penetration of the torso by the stabbing instrument. Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity

  11. An analysis of predictors of morbidity after stab wounds of the pancreas in 78 consecutive injuries.

    Science.gov (United States)

    Krige, J E J; Kotze, U K; Sayed, R; Navsaria, P H; Nicol, A J

    2014-09-01

    Penetrating injuries of the pancreas may result in serious complications. This study assessed the factors influencing morbidity after stab wounds of the pancreas. A retrospective univariate cohort analysis was carried out of 78 patients (74 men) with a median age of 26 years (range: 16-62 years) with stab wounds of the pancreas between 1982 and 2011. The median revised trauma score (RTS) was 7.8 (range: 2.0-7.8). Injuries involved the body (n=36), tail (n=24), head/uncinate process (n=16) and neck (n=2) of the pancreas. All 78 patients underwent a laparotomy. Sixty-five patients had AAST (American Association for the Surgery of Trauma) grade I or II pancreatic injuries and thirteen had grade III, IV or V injuries. Eight patients (10.3%) had an initial damage control operation. Sixty-nine patients (84.6%) had drainage of the pancreas only, six had a distal pancreatectomy and one had a pancreaticoduodenectomy. Most pancreas related complications occurred in patients with AAST grade III injuries; eight patients (10.2%) developed a pancreatic fistula. Four patients (5.1%) died. Grade of pancreatic injury (AAST grade I-II vs grade III-V injuries, pwound, morbidity was high. Increasing AAST grade of injury, high RTS, shock on admission to hospital, need for blood transfusion and repeat laparotomy were significant factors related to morbidity.

  12. Scientific Letter: Stabbing nails into the neck: an unusual self ...

    African Journals Online (AJOL)

    Scientific Letter: Stabbing nails into the neck: an unusual self-damaging behavior mandating neurosurgery. A Aghabiklooei, R Aghabiklooei, N Zamani. Abstract. Scientific Letter - No Abstract Available. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  13. An optimal dynamic interval stabbing-max data structure?

    DEFF Research Database (Denmark)

    Agarwal, Pankaj Kumar; Arge, Lars; Yi, Ke

    2005-01-01

    In this paper we consider the dynamic stabbing-max problem, that is, the problem of dynamically maintaining a set S of n axis-parallel hyper-rectangles in Rd, where each rectangle s ∈ S has a weight w(s) ∈ R, so that the rectangle with the maximum weight containing a query point can be determined...

  14. Non-operative management of abdominal stab wounds -an analysis ...

    African Journals Online (AJOL)

    Patients with abdominal stab wounds presenting with peritonitis, haemodynamic instability, organ evisceration and high spinal cord injury underwent emergency laparotomy. No local wound exploration, diagnostic peritoneal lavage or ultrasound was used. Haematuria in patients without an indication for emergency surgery ...

  15. Intrauterine Insemination (IUI)

    Science.gov (United States)

    ... IUI) Overview Intrauterine insemination ( IUI ) — a type of artificial insemination — is a procedure for treating infertility. Sperm that ... more eggs to be fertilized. Older types of artificial insemination placed the sperm in the vagina. While this ...

  16. Abdominal and lower back pain in pediatric idiopathic stabbing headache.

    Science.gov (United States)

    Kakisaka, Yosuke; Ohara, Tomoichiro; Hino-Fukuyo, Naomi; Uematsu, Mitsugu; Kure, Shigeo

    2014-01-01

    Idiopathic stabbing headache (ISH) is a primary headache syndrome characterized by transient, sharp, stabbing pains located in the first division of the trigeminal nerve. Reports of pediatric ISH are rare, and extracephalic pain in pediatric ISH is extremely rare. Here we report the case of a 7-year-old male patient suffering from frequent, short, stabbing headache, which was occasionally associated with abdominal and lower back pain. Various investigations were normal. He was diagnosed with ISH, and valproic acid was administered to relieve his headache and accompanying symptoms. Our case demonstrates that abdominal and lower back pain may occur in pediatric ISH. This case may provide new evidence linking ISH and migraine by showing that extracephalic symptoms accompanying ISH are similar to those of migraine. We hypothesize that the mechanism underlying the headache and abdominal and lower back pain associated with ISH may be similar to that of a migraine headache. Accumulating additional cases by asking specific questions regarding the presence of the unusual symptoms presented in our case may help to establish a detailed clinical profile of these unfamiliar and peculiar symptoms in the pediatric ISH population.

  17. Terrorist Stabbings-Distinctive Characteristics and How to Prepare for Them.

    Science.gov (United States)

    Merin, Ofer; Sonkin, Roman; Yitzhak, Avraham; Frenkel, Hagai; Leiba, Adi; Schwarz, Alon D; Jaffe, Eli

    2017-10-01

    The number of terror attack incidents is on the increase worldwide. The knife is one of the weapons most commonly used among terrorists. Appropriate preparation in trauma units for coping with the increasing numbers of terrorist-inflicted stabbings is different from the preparation suitable for civilian stabbings. Therapeutic and logistic guidelines need to be adjusted to accommodate those differences. Characterize the unique injuries related to terrorist stabbing, and suggest preparedness actions. Retrospective data on all terrorist-inflicted stabbing incidents between September 2015 and May 2016 were retrieved from the database of the national Israeli emergency medical services and from the Israeli Defense Forces Medical Corps records. There were a total of 414 civilian victims (34 fatalities) of terror incidents. Of these, 161 involved stabbings during 106 separate incidents. There was more than 1 stab wound per patient in approximately 60% of cases, and more than 1 victim in approximately 40% of cases. Unlike civilian stabbings, terrorist stabbings were characterized by more commonly occurring to the upper part of the body, being executed by large knives with high force, and involving multiple and more severe injuries. There is a clear distinction between the characteristics of wounds resulting from civilian stabbings and those incurred by acts of terror. Terrorists intend to injure as many random victims as possible, and trauma units need to be prepared to cope with the simultaneous admission of multiple patients with penetrating and often life-threatening knife wounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Intrauterin graviditet efter Cavatermbehandling

    DEFF Research Database (Denmark)

    Shokouh-Amiri, Ali; Kjaergaard, Niels

    2009-01-01

    A case of intrauterine pregnancy occurring after successful balloon thermal endometrial ablation is described. Although rare, pregnancy after endometrial ablation is possible, and use of a supplemental contraceptive method should be planned. In case of pregnancy after endometrial ablation......, the woman should be informed of the high risk of pregnancy complications, and termination of the pregnancy should be discussed. Udgivelsesdato: 2009-Feb-16...

  19. Forensic evidence in apparel fabrics due to stab events.

    Science.gov (United States)

    Kemp, S E; Carr, D J; Kieser, J; Niven, B E; Taylor, M C

    2009-10-30

    Stab injuries and fatalities have been reported to be the most common crimes of violence in several countries, particularly in those where access to firearms is restricted [J.M. Taupin, F.-P. Adolf, J. Robertson, Examination of damage to textiles, in: J. Robertson, M. Grieve (Eds.), Forensic Examination of Fibres, CRC Press, United States of America, 1999, pp. 65-87; A.C. Hunt, R.J. Cowling, Murder by stabbing, Forensic Sci. Int. 52 (1991) 107-112; D.A. Rouse, Patterns of stab wounds: a six year study, Med. Sci. Law 34 (1994) 67-71]. Analysis of damaged apparel may provide important information about the cause of death and the events leading up to and after the victim's final moments [M.T. Pailthorpe, N.A.G. Johnson, The private forensic scientist and the criminal justice system, in: D. Biles, J. Vernon (Eds.), Private Sector and Community Involvement in the Criminal Justice System: Conference Proceedings, vol. 23, Australian Institute of Criminology, Wellington, 1994, 231-240]. A high proportion of stab wounds occur in the chest and as this area is generally clothed many sharp force cases involve damage to fabrics [J.M. Taupin, F.-P. Adolf, J. Robertson, Examination of damage to textiles, in: J. Robertson, M. Grieve (Eds.), Forensic Examination of Fibres, CRC Press, United States of America, 1999, pp. 65-87; A.C. Hunt, R.J. Cowling, Murder by stabbing, Forensic Sci. Int. 52 (1991) 107-112; D.A. Rouse, Patterns of stab wounds: a six year study, Med. Sci. Law 34 (1994) 67-71]. The structural stabilisation and degradation of fabric due to laundering significantly alters fabric properties [S.E. Gore, R.M. Laing, C.A. Wilson, D.J. Carr, B.E. Niven, Standardizing a pre-treatment cleaning procedure and effects of application on apparel fabrics, Text. Res. J. 76 (2006) 455-464], yet the effect of such on severance morphology does not appear to have been investigated. In this work the effect of blade type (hunting knife, kitchen knife, screwdriver) on new and laundered

  20. The application of PA/CF in stab resistance body armor

    Science.gov (United States)

    Yuan, M. Q.; Liu, Y.; Gong, Z.; Qian, X. M.

    2017-06-01

    Stab resistance body armor (SRBA) is an essential defensive equipment to protect human body against injuries from stabbing. The conventional SRBAs shared low wearing frequency since they are heavy and poor in flexibility. This paper designed a structured stab-resistance plate using the model of crocodile armor and manufactured using 3D printing technology-laser sintering (LS). CF(Carbon fiber) was applied to enhance the stab resistance properties of SRBA. The effects of the material and structure were analysed through the stab resistance property tests based on the national standard GA68-2008. It is found that the stab resistance property of flat plates sintered by PA powder and PA/CF are both weaker than that of the structured plate. The penetrating depth of PA/CF structured plate is significantly 2-mm-less than the pure PA structured plate. The SEM observations confirmed the conclusion that addition of the CF largely improved the plate stab resistance property. Moreover, using PA/CF structured plate to produce the stab resistance body armor would result in a weight reduction by about 30-40% as compared to the existing SRBA that was made up of metal plates, which could largely reduce the wearer physical burden and improve the wearing frequency.

  1. 76 FR 35024 - National Institute of Justice Stab-Resistant Body Armor Standard Workshop

    Science.gov (United States)

    2011-06-15

    ... of Justice Programs National Institute of Justice Stab-Resistant Body Armor Standard Workshop AGENCY... Technology (NIST) are jointly hosting workshop focused on the NIJ Stab-Resistant Body Armor Standard. It is... planning to attend are responsible for their own travel arrangements. Registration information may be found...

  2. Analytical assessment of woven fabrics under vertical stabbing - The role of protective clothing.

    Science.gov (United States)

    Hejazi, Sayyed Mahdi; Kadivar, Nastaran; Sajjadi, Ali

    2016-02-01

    Knives are being used more commonly in street fights and muggings. Therefore, this work presents an analytical model for woven fabrics under vertical stabbing loads. The model is based on energy method and the fabric is assumed to be unidirectional comprised of N layers. Thus, the ultimate stab resistance of fabric was determined based on structural parameters of fabric and geometrical characteristics of blade. Moreover, protective clothing is nowadays considered as a strategic branch in technical textile industry. The main idea of the present work is improving the stab resistance of woven textiles by using metal coating method. In the final, a series of vertical stabbing tests were conducted on cotton, polyester and polyamide fabrics. Consequently, it was found that the model predicts with a good accuracy the ultimate stab resistance of the sample fabrics. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. An autopsy case of suicide by hanging with multiple stab wounds of the neck and chest.

    Science.gov (United States)

    Maeda, H; Imura, M; Higuchi, T; Noguchi, K

    1993-01-01

    We report, from the aspect of 'acting' capability, an autopsy case of suicide by hanging in which multiple deep stab wounds were observed in the neck and chest. A 49-year-old man was found dead in a state typical of hanging. His car was found about 100m away with a blood-stained climber's knife on the seat. Multiple incised and stab wounds were in the neck, with a lesion of the right inner jugular vein. Three penetrating stab wounds of the chest punctured the lungs, with pooling of about 500ml of blood in the left thorax and about 100ml in the right. Two other shallow stab wounds were in the chest. All the above wounds were explainable as self-inflicted. From the autopsy findings and the circumstantial evidence, it was concluded that he walked approximately 100m after stabbing his neck and chest and finally committed suicide by hanging.

  4. Variability of simulants used in recreating stab events.

    Science.gov (United States)

    Carr, D J; Wainwright, A

    2011-07-15

    Forensic investigators commonly use simulants/backing materials to mount fabrics and/or garments on when recreating damage due to stab events. Such work may be conducted in support of an investigation to connect a particular knife to a stabbing event by comparing the severance morphology obtained in the laboratory to that observed in the incident. There does not appear to have been a comparison of the effect of simulant type on the morphology of severances in fabrics and simulants, nor on the variability of simulants. This work investigates three simulants (pork, gelatine, expanded polystyrene), two knife blades (carving, bread), and how severances in the simulants and an apparel fabric typically used to manufacture T-shirts (single jersey) were affected by (i) simulant type and (ii) blade type. Severances were formed using a laboratory impact apparatus to ensure a consistent impact velocity and hence impact energy independently of the other variables. The impact velocity was chosen so that the force measured was similar to that measured in human performance trials. Force-time and energy-time curves were analysed and severance morphology (y, z directions) investigated. Simulant type and knife type significantly affected the critical forensic measurements of severance length (y direction) in the fabric and 'skin' (Tuftane). The use of EPS resulted in the lowest variability in data, further the severances recorded in both the fabric and Tuftane more accurately reflected the dimensions of the impacting knives. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Management of stab wounds to the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    João Baptista Rezende-Neto

    Full Text Available The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE, through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.

  6. An Optimal Dynamic Data Structure for Stabbing-Semigroup Queries

    DEFF Research Database (Denmark)

    Agarwal, Pankaj K.; Arge, Lars; Kaplan, Haim

    2012-01-01

    {R}$, the stabbing-semigroup query asks for computing $\\sum_{s \\in S(q)} \\omega(s)$. We propose a linear-size dynamic data structure, under the pointer-machine model, that answers queries in worst-case $O(\\log n)$ time and supports both insertions and deletions of intervals in amortized $O(\\log n)$ time....... It is the first data structure that attains the optimal $O(\\log n)$ bound for all three operations. Furthermore, our structure can easily be adapted to external memory, where we obtain a linear-size structure that answers queries and supports updates in $O(\\log_B n)$ I/Os, where B is the disk block size....... For the restricted case of a nested family of intervals (either every pair of intervals is disjoint or one contains the other), we present a simpler solution based on dynamic trees...

  7. The spectrum of injuries in buttock stab wounds.

    Science.gov (United States)

    Campion, T; Cross, S

    2017-07-01

    Buttock stab wounds are a surprisingly common and increasing source of presentations to emergency departments. These injuries can have a significant impact on quality of life, and there are a number of often subtle, but significant, injuries that the radiologist must be alert to when interpreting computed tomography examinations in these patients. In this review, we will examine briefly the sociological reasons for the increase in these injuries, discuss appropriate imaging techniques, and provide imaging examples of the clinically important injuries that may be encountered in this region. These injuries include rectal or colonic perforation; genito-urinary trauma, for example urethral injury; injury to the sciatic nerve; and a spectrum of vascular trauma including transection and pseudoaneurysm or arteriovenous fistula formation. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  8. The persistent diagnostic challenge of thoracoabdominal stab wounds.

    Science.gov (United States)

    Berg, Regan J; Karamanos, Efstathios; Inaba, Kenji; Okoye, Obi; Teixeira, Pedro G; Demetriades, Demetrios

    2014-02-01

    Penetrating thoracoabdominal trauma, with potential injury to two anatomic cavities, significantly challenges surgical management, yet this injury pattern has not been reviewed across a large patient series. The trauma registry of a major level 1 center was queried for all adult patients admitted with thoracoabdominal stab wounds between January 1996 and December 2011. The study identified 617 patients; 11% arrived hypotensive (systolic blood pressure undergoing thoracotomy. Among this group, only 1 (2.4%) of 41 had a major thoracic vessel or aortic injury without cardiac trauma. Diaphragmatic injury (DI) occurred in 224 (38%) of 595, with 72 (32.1%) of these 224 demonstrating no computed tomographic evidence of DI. Either hollow viscus injury or DI occurred in 50%. Only 36.8% of liver, 58% of spleen, and 29.8% of kidney injuries required surgical repair. The need for dual-cavitary intervention was associated with a precipitous increase in patient mortality. Patients with thoracoabdominal stab wounds present considerable clinical challenges due to high surgical need, high occult DI incidence, persistently high rates of negative laparotomy, and significant mortality with dual-cavitary intervention. Many patients with solid-organ injuries do not require intervention. High incidence of hollow viscus injury and DI ultimately limits nonoperative management. Laparoscopy is necessary to exclude occult DI. In unstable patients, determination of which anatomic cavity to explore primarily requires exclusion of cardiac injury. In those with equivocal clinical or ultrasonographic evidence of cardiac trauma, laparotomy, with transdiaphragmatic pericardial window, if a causative abdominal injury is not immediately apparent, seems the most effective strategy. Epidemiologic study, level III.

  9. Stab Resistance of Shear Thickening Fluid (STF)-Kevlar Composites for Body Armor Applications

    National Research Council Canada - National Science Library

    Egres Jr., R. G; Decker, M. J; Halbach, C. J; Lee, Y. S; Kirkwood, J. E; Kirwood, K. M; Wagner, N. J; Wetzel, E. D

    2004-01-01

    The stab resistance of shear thickening fluid (STF)-Kevlar and STF-Nylon fabric composites are investigated and found to exhibit significant improvements over neat fabric targets of equivalent areal density...

  10. STAB INJURY: RETROSPECTIVE AND PROSPECTIVE STUDY IN TERTIARY CENTRE S IN CENTRAL INDIA

    OpenAIRE

    Raikwar; Odiya; Ashish; Sachin

    2015-01-01

    AIMS AND OBJECTIVES: The aim of this study was to , 1. E valuate the incidence of stab injuries admitting in our institute, t o know various parameter and its association with injuries such as age group, sex ratio, clinical presentation . 2. V arious surgical interventi on and conservative treatment according the nature of stab injuries and through examination. 3. M orbidity and mortality of these patients , settings and design . ...

  11. Perforation of the ileum after a stab wound of the gluteal region: a case report

    OpenAIRE

    van Oldenrijk, Jakob; Ünlü, Çaĝdaş; van Wagensveld, Bart A

    2007-01-01

    We present a case of a patient with a seemingly insignificant single gluteal stab wound which led to a solitary perforation of the ileum and delayed peritonitis. This case report illustrates that, despite the absence of any signs of bowel perforation on presentation, a patient may deteriorate gradually in the subsequent hours. This demonstrates the role of clinical observation in high risk gluteal stab wound patients.

  12. Intravesical migration of an intrauterine device

    OpenAIRE

    Gyasi-Sarpong, Christian Kofi; Maison, Patrick Opoku Manu; Morhe, Emmanuel; Aboah, Ken; Appiah, Kwaku Addai-Arhin; Azorliade, Roland; Baah-Nyamekye, Kofi; Otu-Boateng, Kwaku; Amoah, George; Antwi, Isaac; Frimpong-Twumasi, Benjamin; Arthur, Douglas

    2016-01-01

    Background Intrauterine contraceptive device is the most common method of reversible contraception in women. The intrauterine contraceptive device can perforate the uterus and can also migrate into pelvic or abdominal organs. Perforation of the urinary bladder by an intrauterine contraceptive device is not common. In West Africa, intravesical migration of an intrauterine contraceptive device has been rarely reported. In this report, we present a case of an intrauterine contraceptive device mi...

  13. ANTENATAL PROGNOSIS OF INTRAUTERINE INFECTIONS

    Directory of Open Access Journals (Sweden)

    Людмила Владимировна Ренге

    2016-12-01

    Conclusion. Taking into account the clinical and immunological predictors the integrated approach allows us to estimate the risk of intrauterine infection and the risk of complications during the neonatal period with a probability of 90 %.

  14. Candida albicans spondylodiscitis following an abdominal stab wound: forensic considerations.

    Science.gov (United States)

    Savall, Frederic; Dedouit, Fabrice; Telmon, Norbert; Rougé, Daniel

    2014-03-01

    Candida albicans spondylodiscitis is a fungal infection of the spine which is still unusual in spite of the increasing frequency of predisposing factors. A 22-year-old man received an abdominal stab wound during a physical assault. Initial medical care included surgery, prolonged use of indwelling vascular catheters with administration of broad-spectrum antibiotics, and hospitalization in intensive care. Two months after the event, the victim experienced back pain in the right lumbar region and septic spondylodiscitis secondary to C. albicans was diagnosed three weeks later. This case is noteworthy because of its clinical forensic context. In France, the public prosecutor orders a medico-legal assessment after an assault for all living victims in order to establish a causal relationship between the assault and its complications. In our case, the patient presented numerous risk factors for candidemia and the forensic specialist reasonably accepted that the causal relationship was certain but indirect. We have only found one published case of spondylodiscitis after an abdominal penetrating injury and the pathogenic agent was not mentioned. We have found no case reported in a forensic context. This unusual observation shows that it may be genuinely difficult to prove the causal relationship between an abdominal penetrating injury and an unusual infectious complication such as fungal spondylodiscitis. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  15. STAB INJURY: RETROSPECTIVE AND PROSPECTIVE STUDY IN TERTIARY CENTRE S IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Raikwar

    2015-07-01

    Full Text Available AIMS AND OBJECTIVES: The aim of this study was to , 1. E valuate the incidence of stab injuries admitting in our institute, t o know various parameter and its association with injuries such as age group, sex ratio, clinical presentation . 2. V arious surgical interventi on and conservative treatment according the nature of stab injuries and through examination. 3. M orbidity and mortality of these patients , settings and design . The study was conducted in a retrospective and prospec tive manner and included cases b etween January 2009 and September 2013. METHODS AND MATERIAL S: 424 patients admitted with stab injuries in ICU and ward . Various surgical interventions were done according to standard indication such as laparotomies , thoracotomies, vascular repair etc. , and resul ts reported. RESULTS: Out of 424 patients t here were over all 413 mal es (97.4% and 11 female s (2.6% highest number of cases (226 in the third decade(21 - 30 i.e. 53.3% maximum number of cases are from 11 - 40 yrs. Majority of the stab wounds were homicidal in nature comprising 386 cases i.e. 91 % followed by are accidental. Chaku ( knife were the most common weapon . The Chaku was used in 351 cases i.e. 82.8% maximun numbers of patients 309 were presented with localised tende r ness at site of stab injury i.e 72.87%. In the perspective of management 244 abdominal stab that there were total 189(44.6% exploratory laparotomy . In 189 laparotomies peritoneal breech in 114 patients on local examination / exploration was the major indic ation there were 114 i.e ., 60.3% CONCLUSION: Stab injuri es are becoming common now a days because people often try to settle interpersonal relationship and political problems by mean of stabbing, although its incidence more in our country as compare d to European studies because of overpopulation unemployment and poverty. Incidence of stab injury can be reduced by improving the social morale of people especially the younger generation by

  16. A combined experimental and numerical study of stab-penetration forces.

    Science.gov (United States)

    Annaidh, Aisling Ní; Cassidy, Marie; Curtis, Michael; Destrade, Michel; Gilchrist, Michael D

    2013-12-10

    The magnitude of force used in a stabbing incident can be difficult to quantify, although the estimate given by forensic pathologists is often seen as 'critical' evidence in medico-legal situations. The main objective of this study is to develop a quantitative measure of the force associated with a knife stabbing biological tissue, using a combined experimental and numerical technique. A series of stab-penetration tests were performed to quantify the force required for a blade to penetrate skin at various speeds and using different 'sharp' instruments. A computational model of blade penetration was developed using ABAQUS/EXPLICIT, a non-linear finite element analysis (FEA) commercial package. This model, which incorporated element deletion along with a suitable failure criterion, is capable of systematically quantifying the effect of the many variables affecting a stab event. This quantitative data could, in time, lead to the development of a predictive model that could help indicate the level of force used in a particular stabbing incident. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Intrauterine radiation exposures and mental retardation

    International Nuclear Information System (INIS)

    Miller, R.W.

    1988-01-01

    Small head size and mental retardation have been known as effects of intrauterine exposure to ionizing radiation since the 1920s. In the 1950s, studies of Japanese atomic-bomb survivors revealed that at 4-17 wk of gestation, the greater the dose, the smaller the brain (and head size), and that beginning at 0.5 Gy (50 rad) in Hiroshima, mental retardation increased in frequency with increasing dose. No other excess of birth defects was observed. Otake and Schull (1984) pointed out that the period of susceptibility to mental retardation coincided with that for proliferation and migration of neuronal elements from near the cerebral ventricles to the cortex. Mental retardation could be the result of interference with this process. Their analysis indicated that exposures at 8-15 wk to 0.01-0.02 Gy (1-2 rad) doubled the frequency of severe mental retardation. This estimate was based on small numbers of mentally retarded atomic-bomb survivors. Although nuclear accidents have occurred recently, new cases will hopefully be too rare to provide further information about the risk of mental retardation. It may be possible, however, to learn about lesser impairment. New psychometric tests may be helpful in detecting subtle deficits in intelligence or neurodevelopmental function. One such test is PEERAMID, which is being used in schools to identify learning disabilities due, for example, to deficits in attention, short- or long-term memory, or in sequencing information. This and other tests could be applied in evaluating survivors of intrauterine exposure to various doses of ionizing radiation. The results could change our understanding of the safety of low-dose exposures

  18. Intrauterine radiation exposures and mental retardation

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.W.

    1988-08-01

    Small head size and mental retardation have been known as effects of intrauterine exposure to ionizing radiation since the 1920s. In the 1950s, studies of Japanese atomic-bomb survivors revealed that at 4-17 wk of gestation, the greater the dose, the smaller the brain (and head size), and that beginning at 0.5 Gy (50 rad) in Hiroshima, mental retardation increased in frequency with increasing dose. No other excess of birth defects was observed. Otake and Schull (1984) pointed out that the period of susceptibility to mental retardation coincided with that for proliferation and migration of neuronal elements from near the cerebral ventricles to the cortex. Mental retardation could be the result of interference with this process. Their analysis indicated that exposures at 8-15 wk to 0.01-0.02 Gy (1-2 rad) doubled the frequency of severe mental retardation. This estimate was based on small numbers of mentally retarded atomic-bomb survivors. Although nuclear accidents have occurred recently, new cases will hopefully be too rare to provide further information about the risk of mental retardation. It may be possible, however, to learn about lesser impairment. New psychometric tests may be helpful in detecting subtle deficits in intelligence or neurodevelopmental function. One such test is PEERAMID, which is being used in schools to identify learning disabilities due, for example, to deficits in attention, short- or long-term memory, or in sequencing information. This and other tests could be applied in evaluating survivors of intrauterine exposure to various doses of ionizing radiation. The results could change our understanding of the safety of low-dose exposures.

  19. [Intrauterine herpes simplex virus infection].

    Science.gov (United States)

    Hoppen, T; Eis-Hübinger, A M; Schild, R L; Enders, G; Hansmann, M; Rister, M; Bartmann, P

    2001-01-01

    Early fetal herpes simplex virus (HSV) infection is rarely documented. Only the minority of affected fetuses survive this condition. At 19 weeks of gestation the first episode of a genital HSV-infection of a pregnant woman was treated with local interferon beta. At 34 weeks of gestation hydrocephalus with secondary microcephaly and microphthalmia of both eyes was detected by ultrasonography. In the amniotic fluid HSV type 2 (HSV-2) was isolated and HSV-2-DNA was detected by PCR. The serum of the mother proved positive for HSV-2 (glycoprotein G2)-specific IgG-antibodies. No other infectious causes were apparent on further testing. At 35 + 4 weeks gestation a small-for-gestational-age neonate (2130 g) with microcephaly (29 cm head circumference) was born by spontaneous vaginal delivery. Scarce ulcerative skin lesions and vesicles, hepatosplenomegaly and microphthalmia were diagnosed. Furthermore, encephalomalacia with parenchymal destruction, cataract of both eyes and aplasia of the maculae and papillae were found. HSV-2-PCR was tested positive in chorionic cells and an umbilical segment of the placenta as well as in swabs from both eyes, throat, and a herpetic skin lesion collected during the first 5 days of life. HSV-IgM-antibodies were found in the umbilical cord blood. Local and intravenous treatment with aciclovir was started. The infant exhibited signs of a severely malfunctioning central nervous system. At the age of 4 months the boy suffered from generalised cerebral seizures. He died at the age of 9 months as a consequence of respiratory insufficiency with consecutive circulation failure. The case of an intrauterine HSV-2-infection is presented. The time of onset of fetal infection was most probably at the time of the maternal disease (19 weeks of gestation). Inspite of the very early infection the fetus did not die in utero. Especially, if a primary genital HSV-2-infection of a pregnant woman is suspected, which can be proven by serological means only

  20. [Antibody induction after intrauterine interventions].

    Science.gov (United States)

    Hoch, J; Giers, G; Bald, R; Hansmann, M; Hanfland, P

    1993-06-01

    Immunohematologic and clinical data, i.e., antibody profile, location of the placenta, mode of cordocentesis, obtained from 48 pregnant patients with irregular erythrocyte antibodies during the last 2 years have been retrospectively evaluated. All fetuses of the patients received intrauterine transfusions for the treatment of fetal erythroblastosis. In 16 (33%) patients (group I) a secondarily induced antibody was detected after the onset of intrauterine transfusion therapy. 32 (67%) patients (group II) did not further develop new antibody specificities. Group I exhibited a significantly different distribution in the location of the placenta (p pregnant women. In group I a 5-fold higher rate of anterior than posterior placenta location was found. The mode of cordocentesis differed significantly (p antibodies by invasive intrauterine interventions in our patients depended indirectly on the location of the placenta and directly on the mode of the puncture (trans- vs. paraplacental access).

  1. A Dynamic Stabbing-Max Data Structure with Sub-Logarithmic Query Time

    OpenAIRE

    Nekrich, Yakov

    2011-01-01

    In this paper we describe a dynamic data structure that answers one-dimensional stabbing-max queries in optimal $O(\\log n/\\log\\log n)$ time. Our data structure uses linear space and supports insertions and deletions in $O(\\log n)$ and $O(\\log n/\\log \\log n)$ amortized time respectively. We also describe a $O(n(\\log n/\\log\\log n)^{d-1})$ space data structure that answers $d$-dimensional stabbing-max queries in $O((\\log n/\\log\\log n)^{d})$ time. Insertions and deletions are supported in $O((\\lo...

  2. Experimental study of thermal comfort on stab resistant body armor.

    Science.gov (United States)

    Ji, Tingchao; Qian, Xinming; Yuan, Mengqi; Jiang, Jinhui

    2016-01-01

    This research aims to investigate the impacts of exercise intensity and sequence on human physiology parameters and subjective thermal sensation when wearing stab resistant body armor under daily working conditions in China [26 and 31 °C, 45-50 % relative humidity (RH)], and to investigate on the relationship between subjective judgments and objective parameters. Eight male volunteers were recruited to complete 3 terms of exercises with different velocity set on treadmill for 90 min at 26 °C and 31 °C, 45-50 % RH. In Exercise 1 volunteers were seated during the test. In Exercise 2, volunteers walked with the velocity of 3 km/h in the first 45 min and 6 km/h in the left 45 min. In Exercise 3, volunteers walked with the velocity of 6 km/h in the first 45 min and 3 km/h in the left 45 min. The body core temperature, skin temperature and subjective judgments were recorded during the whole process. Analysis of variance was performed among all the tests. Individual discrepancy of Exercise 1 is larger than that of Exercise 2 and 3. On the premise of the same walking distance and environmental conditions, core temperature in Exercise 3 is about 0.2 °C lower than that in Exercise 2 in the end; and with the velocity decrease from 6 km/h to 3 km/h in the end, thermal tolerance of Exercise 3 is about 1 degree lower than that in Exercise 2. Skin temperatures of human trunk were at least 1 °C higher than that of limbs. Activity narrows the individual discrepancy on core temperature. Within experimental conditions, decreasing of intensity at last stage makes the core temperature lower and the whole process much tolerable. The core temperature is more sensitive to the external disturbance on the balance of the whole body, and it can reflect the subjective thermal sensation and physical exertion.

  3. Development of a high-density nonwoven structure to improve the stab resistance of protective clothing material.

    Science.gov (United States)

    Bao, Limin; Wang, Yanling; Baba, Takeichiro; Fukuda, Yasuhiro; Wakatsuki, Kaoru; Morikawa, Hideaki

    2017-12-07

    The purpose of this research was to enhance the stab resistance of protective clothing material by developing a new high-density nonwoven structure. Ice picks often injure Japanese police officers due to the strict regulation of swords in the country. Consequently, this study was designed to improve stab resistance against ice picks. Most existing anti-stab protective clothing research has focused on various fabrics impregnated with resin, an approach that brings with it problems of high cost and complicated processing. Seldom has research addressed the potential for improving stab resistance by using nonwoven structures, which exhibit better stab resistance than fabric. In this research, we prepared a series of nonwoven structures with densities ranging from about 0.14 g/cm 3 to 0.46 g/cm 3 by varying the number of stacked layers of Kevlar/polyester nonwoven under a hot press. We then proposed two methods for producing such hot-press nonwovens: the multilayer hot-press method and the monolayer hot-press method. Stab resistance was evaluated according to NIJ Standard-0115.00. We also investigated the relationship among nonwoven density, stab resistance, and flexural rigidity, and here we discuss the respective properties of the two proposed methods. Our results show that stab resistance and flexural rigidity increase with nonwoven density, but flexural rigidity of nonwovens prepared using the monolayer hot-press method only shows a slight change as nonwoven density increases. Though the two methods exhibit little difference in maximum load, the flexural rigidity of nonwovens prepared using the monolayer hot-press method is much lower, which contributes to superior wear comfort. Finally, we investigated the mechanism behind the stabbing process. Stabbing with an ice pick is a complicated process that involves many factors. Our findings indicate that nonwovens stop penetration primarily in two ways: nonwoven deformation and fiber fractures.

  4. Heterotopic pregnancy following intrauterine insemination ...

    African Journals Online (AJOL)

    2011-04-27

    Apr 27, 2011 ... Clomiphene citrate, gonadotropin stimulation (hCG), and intrauterine insemination using donor sperm. The resulting pregnancy was later diagnosed as heterotopic pregnancy ... Presence of corpus luteum cyst of pregnancy in early ultrasound should be an index of suspicious of a possible heterotopic ...

  5. Language development in preschool children born after asymmetrical intrauterine growth retardation.

    Science.gov (United States)

    Simić Klarić, Andrea; Kolundžić, Zdravko; Galić, Slavka; Mejaški Bošnjak, Vlatka

    2012-03-01

    After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive functions. The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. There were statistically significant differences (p language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head [(Actual head circumference - head circumference at birth)/(Body weight - birth weight)] and language outcome. Children with neonatal complications had lower results (p language comprehension and total expressive language. Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  6. Clinical patterns of primary stabbing headache: a single clinic-based prospective study.

    Science.gov (United States)

    Kim, Dong Yeop; Lee, Mi Ji; Choi, Hyun Ah; Choi, Hanna; Chung, Chin-Sang

    2017-12-01

    The clinical features and disease courses of primary stabbing headache (PSH) are diverse. We aimed to identify distinct clinical patterns of PSH. We prospectively screened consecutive first-visit patients who presented with stabbing headache at the Samsung Medical Centre Headache Clinic from June 2015 to March 2016. Demographics, headache characteristics, and disease courses were prospectively evaluated. After discerning factors related to the chronicity at the time of presentation, clinical patterns were identified based on the frequency (daily vs. intermittent), clinical course (remitted or not), and total disease duration (3 months). In the 65 patients with PSH included in this study, monophasic (n = 31), intermittent (n = 17), and chronic daily (n = 12) patterns were identified. The median disease durations were 9 days for monophasic PSH, 9 months for chronic daily PSH, and 2 years for intermittent PSH. The features of monophasic PSH were greater severity, single and side-locked locations, more attacks per day, daily occurrence, and good treatment response. Chronic daily PSH was associated with female predominance, longer-lasting stabs, and multiple or migrating locations on bilateral or alternating sides. The characteristics of intermittent PSH included female predominance and sporadic stabs with less intensity. Our study demonstrated distinct clinical patterns of PSH. In addition to help early recognition of disease, our findings suggest different pathophysiologic mechanisms. Future prospective studies are required to reveal the etiologies of these different PSH patterns and their optimal treatment strategies.

  7. Influence of Chemical Surface Modification of Woven Fabrics on Ballistic and Stab Protection of Multilayer Packets

    Directory of Open Access Journals (Sweden)

    Diana GRINEVIČIŪTĖ

    2014-06-01

    Full Text Available In order to achieve enhanced protective and wear (flexibility, less bulkiness properties of ballistic and stab protecting panels the investigation of chemical surface modification of woven p-aramid fabrics was performed applying different chemical composition shear thickening fluid (STF which improves friction inside fabric structure. For the chemical treatment silicic acid and acrylic dispersion water solutions were used and influence of their different concentrations on panels’ protective properties were investigated. Results of ballistic tests of multilayer protective panel have revealed that shear thickening effect was negligible when shooting at high energy range (E > 440 J. Determination of stab resistance of p-aramid panels has shown that different chemical composition of STFs had different influence on protective properties of the panels. Application of low concentrations of silicic acid determined higher stab resistance values comparing to higher concentrations of acrylic dispersion water solutions. At this stage of research stab tests results as ballistic ones determined that STF application for multilayer p-aramid fabrics protective panels is more efficient at low strike energy levels. DOI: http://dx.doi.org/10.5755/j01.ms.20.2.3138

  8. Virtual casting of stab wounds in cartilage using micro-computed tomography.

    Science.gov (United States)

    Pounder, Derrick J; Sim, Louise J

    2011-06-01

    In homicidal stabbings using a serrated knife, stab wounds involving costal cartilage leave striations on the cut surface of the cartilage from the serration points on the blade edge. Class characteristics of the serrated blade can be determined from the striation marks, and individualizing characteristics may be seen also. The traditional method for recording the striation marks involves the pernickety technique of casting with dental impression material. We assessed the potential utility of micro-computed tomography scanning of the stab track as a technique for nondestructive recording of striation patterns and virtual casting of them. Stab tracks in porcine cartilage, produced with a coarsely serrated blade, were scanned with a bench-top micro-computed tomography scanner. The typical irregularly regular striation pattern could be demonstrated, and the images manipulated, using proprietary software to produce a virtual cast. Whether the technology will have sufficient resolution to image not only class characteristic tool marks but also the much finer individualizing tool marks remains to be evaluated, but the technology shows considerable promise.

  9. STABILITY OF PLASMIDS IN 5 STRAINS OF SALMONELLA MAINTAINED IN STAB CULTURE AT DIFFERENT TEMPERATURES

    DEFF Research Database (Denmark)

    Olsen, J. E.; Brown, D. J.; Baggesen, Dorte Lau

    1994-01-01

    Four strains of Salmonella berta and one of Salm. enteritidis were stored as stab cultures in sugar-free agar at 5 degrees, 22 degrees and 30 degrees C and in 15% glycerol at -80 degrees C. The stability of the plasmid profiles in each of the strains was monitored over a period of 2.5 years. Plas...

  10. Televisioon päästab maailma / Mari Laaniste

    Index Scriptorium Estoniae

    Laaniste, Mari, 1977-

    2008-01-01

    George Clooney mängufilm "Head õhtut ja õnn kaasa" ("Good Night, and Good Luck") teleajakirjanik Edward R. Murrow võitlusest senaator Joseph McCarthy vastu (Ameerika Ühendriigid 2005). Lühiandmed E.R. Murrow' osatäitja David Strathairni kohta

  11. Impact of body mass index on injury in abdominal stab wounds: implications for management.

    Science.gov (United States)

    Bloom, Matthew B; Ley, Eric J; Liou, Douglas Z; Tran, Tri; Chung, Rex; Melo, Nicolas; Margulies, Daniel R

    2015-07-01

    Although it is assumed that obese patients are naturally protected against anterior abdominal stab wounds, the relationship has never been formally studied. We sought to examine the impact of body mass index (BMI) on severity of sustained injury, need for operation, and patient outcomes. We conducted a review of all patients presenting with abdominal stab wounds at an urban level I trauma center from January 2000-December 2012. Patients were divided into groups based on their BMI (35). Data abstracted included baseline demographics, physiologic data, and characterization of whether the stab wound had violated the peritoneum, caused intra-abdominal injury, or required an operation that was therapeutic. The one-sided Cochran-Armitage trend test was used for significance testing of the protective effect. Of 281 patients with abdominal stab wounds, 249 had complete data for evaluation. Chest and abdomen abbreviated injury scale trends decreased with increasing BMI, as did overall injury severity score, the percent of patients severely injured (injury severity score ≥ 25), and length of intensive care unit stay. Rates of peritoneal violation (100%, 84%, 77%, and 74%; P = 0.077), visceral injury (83%, 56%, 50%, and 30%; P = 0.022), and injury requiring a therapeutic operation (67%, 45%, 40%, and 20%; P = 0.034) all decreased with increasing BMI. Patients in the thinnest group required an operation three times more often than those in the most obese. Increased BMI protects patients with abdominal stab wounds and is associated with lower incidence of severe injury and need for operation. Heavier patients may be more suitable to observation and serial examinations, whereas very thin patients are more likely to require an operation and be critically injured. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Ovarian transmigration of intrauterine device.

    Science.gov (United States)

    Rovati, Marco; Raveglia, Federico; Baisi, Alessandro; De Simone, Matilde; Cioffi, Ugo

    2016-12-01

    Extrauterine translocation of intrauterine device (IUD) to peritoneal cavity is an uncommon event, moreover the ovarian embedding of a transmigrated IUD is very rare, and only two previous cases have been reported in the literature. We present a single case treated with laparoscopy. The aims of this study were to focus attention on the utility of preoperative computed tomography in planning the best surgical approach and to describe the two-port technique. © 2016 Japan Society of Obstetrics and Gynecology.

  13. Intrauterine Devices Penetrated and Migrated: CT Findings

    International Nuclear Information System (INIS)

    Mejia Restrepo, Jorge; Lopez, Juan Esteban; Aldana Sepulveda, Natalia; Ruiz Zabaleta, Tania; Mazzaro Mauricio

    2011-01-01

    Intrauterine devices have been used for over 40 years, and they constitute the most widely accepted method of contraception among women because of the low rates of complications and low cost. Although uncommon, with the growing use of multidetector CT penetrated and migrated intrauterine devices have become a more common incidental finding. In some cases, intrauterine devices migrate to adjacent viscera, in particular the bladder and bowel and may give rise to symptoms. Consequently tomographic localization and characterization are essential for treatment planning.

  14. Intravesical migration of an intrauterine device.

    Science.gov (United States)

    Gyasi-Sarpong, Christian Kofi; Maison, Patrick Opoku Manu; Morhe, Emmanuel; Aboah, Ken; Appiah, Kwaku Addai-Arhin; Azorliade, Roland; Baah-Nyamekye, Kofi; Otu-Boateng, Kwaku; Amoah, George; Antwi, Isaac; Frimpong-Twumasi, Benjamin; Arthur, Douglas

    2016-01-02

    Intrauterine contraceptive device is the most common method of reversible contraception in women. The intrauterine contraceptive device can perforate the uterus and can also migrate into pelvic or abdominal organs. Perforation of the urinary bladder by an intrauterine contraceptive device is not common. In West Africa, intravesical migration of an intrauterine contraceptive device has been rarely reported. In this report, we present a case of an intrauterine contraceptive device migration into the urinary bladder of a 33 year old African woman at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. A 33 year old African woman presented with persistent urinary tract infection of 7 months duration despite appropriate antibiotic treatments. An abdominal ultrasonography revealed a urinary bladder calculus which was found to be an intrauterine contraceptive device on removal at cystoscopy. She got pregnant whilst having the intrauterine contraceptive device in place and delivered at term. The presence of recurrent or persistent urinary tract infection in any woman with an intrauterine contraceptive device should raise the suspicion of intravesical migration of the intrauterine contraceptive device.

  15. Influence of intrauterine and extrauterine growth on neurodevelopmental outcome of monozygotic twins

    Directory of Open Access Journals (Sweden)

    R.K. Reolon

    2008-08-01

    Full Text Available There have been indications that intrauterine and early extrauterine growth can influence childhood mental and motor function. The objective of the present study was to evaluate the influence of intrauterine growth restriction and early extrauterine head growth on the neurodevelopmental outcome of monozygotic twins. Thirty-six monozygous twin pairs were evaluated at the corrected age of 12 to 42 months. Intrauterine growth restriction was quantified using the fetal growth ratio. The effects of birth weight ratio, head circumference at birth and current head circumference on mental and motor outcomes were estimated using mixed-effect linear regression models. Separate estimates of the between (interpair and within (intrapair effects of each measure on development were thus obtained. Neurodevelopment was assessed with the Bayley Scales of Infant Development, 2nd edition, by a psychologist blind to the exposure. A standardized neurological examination was performed by a neuropediatrician who was unaware of the exposures under investigation. After adjustment, birth weight ratio and head circumference at birth were not associated with motor or mental outcomes. Current head circumference was associated with mental but not with motor outcomes. Only the intrapair twin effect was significant. An increase of 1 cm in current head circumference of one twin compared with the other was associated with 3.2 points higher in Mental Developmental Index (95%CI = 1.06-5.32; P < 0.03. Thus, no effect of intrauterine growth was found on cognition and only postnatal head growth was associated with cognition. This effect was not shared by the co-twin.

  16. Complex Suicide by Self-stabbing and Drowning: A Case Report and a Review of Literature.

    Science.gov (United States)

    Peyron, Pierre-Antoine; Casper, Thierry; Mathieu, Olivier; Musizzano, Yuri; Baccino, Eric

    2018-03-01

    Sharp force injuries and drowning are methods exceptionally combined in complex suicides. We report a challenging case of complex suicide by self-stabbing and drowning that illustrates the difficulty in discriminating between homicide and suicide in such circumstances of death. The corpse of a young man was found submerged in a river, stabbed nine times with two wounds that had penetrated the thorax and had caused lung injuries and a hemopneumothorax. The postmortem and histological examinations were consistent with a death caused by drowning, but the manner of death still remained undetermined. Police investigation finally concluded to a suicide, although no suicide note had been left and the victim had no underlying diagnosed mental disorder. The parameters that may help distinguish suicide from homicide at the autopsy should be interpreted in light of a thorough forensic investigation to determine the exact manner of death in such a case. © 2017 American Academy of Forensic Sciences.

  17. REVERSIBLE CORTICAL BLINDNESS FOLLOWING SUCCESSFUL SURGICAL REPAIR OF TWO STAB WOUNDS IN THE HEART

    Directory of Open Access Journals (Sweden)

    Zaiton A

    2008-01-01

    Full Text Available This report describes a case of cortical blindness that followed successful surgical repair of two stab wounds in the heart in a 29-year old Libyan man. The patient presented in a state of pre cardiac arrest (shock and low cardiac output status, following multiple chest stab wounds. Chest tube was immediately inserted. Surgery was urgently performed suturing the two wounds; in the root of the aorta and in the left ventricle, and haemostasis was secured. Cardiac arrest was successfully prevented. The patient recovered smoothly, but 24 hours later he declared total blindness. Ophtalmic and neurological examinations and investigations that included fundoscopy, Electroencephalograms (EEGs and Computed Tomography Scans revealed no abnormalities, apart from absence of alpha waves in the EEGs. We diagnosed the case as cortical blindness and continued caring for the patient conservatively. Three days later, the patient regained his vision gradually and was discharged on the 7th postoperative day without any remarks.

  18. Serial knife stabbings with HIV exposure--implications for post-exposure prophylaxis.

    Science.gov (United States)

    Jorgensen, Pernille; Marcus, Ulrich; Albrecht, Helmut; Suttorp, Norbert; Schürmann, Dirk

    2010-01-01

    Thirty-three persons became victims of a serial knife stabbing incident. One of the first victims one day later disclosed that he was HIV-infected. Thereafter thirty-one victims initiated HIV post-exposure prophylaxis (PEP), one exposed patient declined. None of the victims evaluated had seroconverted six months later. In most such incidents HIV exposure will be difficult to rule out as reliable information on the HIV serostatus of all serial victims will be lacking. It appears prudent, however, to inform serial stab victims about the potential risk of HIV transmission and to at least consider PEP in such scenarios. 2009 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Astrocyte morphology after cortical stab wound revealed by single-cell confocal 3D morphometry

    Czech Academy of Sciences Publication Activity Database

    Chvátal, Alexandr; Anděrová, Miroslava; Petřík, David; Syková, Eva

    č. 2 (2003), s. 63 ISSN 0894-1491. [European Meeting on Glial Cell Function in Health and Disease /6./. Berlín, 03.09.2003-06.09.2003] R&D Projects: GA ČR GA305/02/1528; GA MŠk LN00A065 Institutional research plan: CEZ:AV0Z5039906; CEZ:MSM 111300004 Keywords : cortical stab wound * morphometry Subject RIV: FH - Neurology Impact factor: 4.677, year: 2003

  20. IP-telefon säästab oluliselt sidekulusid / Kristjan Otsmann

    Index Scriptorium Estoniae

    Otsmann, Kristjan, 1971-

    2005-01-01

    Telekomifirma Norby Telecomi poolt pakutavast IP-telefonist ehk helistamisest läbi Interneti, millega saab vähendada sidekulusid mitmeid kordi. Erinevatest internetipõhise kõnesidelahenduse lisateenustest. Vt. samas: Saaremaa Spa Hotellid säästab tuhandeid kroone kuus [intervjuu Saaremaa Spa Hotellide IT-juhiga Andri Võrguga]; Kuus olulist tööd enne IP-lahenduse tellimist

  1. Efficacy of Intrauterine Device in the Treatment of Intrauterine Adhesions

    Science.gov (United States)

    Salma, Umme; Xue, Min; Md Sayed, Ali Sheikh; Xu, Dabao

    2014-01-01

    The primary purpose of this paper is to assess the efficacy of the use of the intrauterine device (IUD) as an adjunctive treatment modality, for intrauterine adhesions (IUAs). All eligible literatures were identified by electronic databases including PubMed, Scopus, and Web of Science. Additional relevant articles were identified from citations in these publications. There were 28 studies included for a systematic review. Of these, 5 studies were eligible for meta-analysis and 23 for qualitative assessment only. Twenty-eight studies related to the use of IUDs as ancillary treatment following adhesiolysis were identified. Of these studies, 25 studies at least one of the following methods were carried out as ancillary treatment: Foley catheter, hyaluronic acid gel, hormonal therapy, or amnion graft in addition to the IUD. There was one study that used IUD therapy as a single ancillary treatment. In 2 studies, no adjunctive therapy was used after adhesiolysis. There was a wide range of reported menstrual and fertility outcomes which were associated with the use of IUD combined with other ancillary treatments. At present, the IUD is beneficial in patients with IUA, regardless of stage of adhesions. However, IUD needs to be combined with other ancillary treatments to obtain maximal outcomes, in particular in patients with moderate to severe IUA. PMID:25254212

  2. Efficacy of Intrauterine Device in the Treatment of Intrauterine Adhesions

    Directory of Open Access Journals (Sweden)

    Umme Salma

    2014-01-01

    Full Text Available The primary purpose of this paper is to assess the efficacy of the use of the intrauterine device (IUD as an adjunctive treatment modality, for intrauterine adhesions (IUAs. All eligible literatures were identified by electronic databases including PubMed, Scopus, and Web of Science. Additional relevant articles were identified from citations in these publications. There were 28 studies included for a systematic review. Of these, 5 studies were eligible for meta-analysis and 23 for qualitative assessment only. Twenty-eight studies related to the use of IUDs as ancillary treatment following adhesiolysis were identified. Of these studies, 25 studies at least one of the following methods were carried out as ancillary treatment: Foley catheter, hyaluronic acid gel, hormonal therapy, or amnion graft in addition to the IUD. There was one study that used IUD therapy as a single ancillary treatment. In 2 studies, no adjunctive therapy was used after adhesiolysis. There was a wide range of reported menstrual and fertility outcomes which were associated with the use of IUD combined with other ancillary treatments. At present, the IUD is beneficial in patients with IUA, regardless of stage of adhesions. However, IUD needs to be combined with other ancillary treatments to obtain maximal outcomes, in particular in patients with moderate to severe IUA.

  3. Laparoscopic Retrieval Of Perforated Intrauterine Device ...

    African Journals Online (AJOL)

    We present a case of successful laparoscopic retrieval of a perforated intrauterine device (Lippes loop). The Lippes loop was inserted after manual intrauterine adhesiolysis as a treatment of uterine synaechia presenting as secondary amenorrhoea of 20 months duration. The uterine perforation in this patient did not occur at ...

  4. Successful Intrauterine Pregnancy following salpingostomy; Case ...

    African Journals Online (AJOL)

    by salpingostomy, after which she had spontaneous abortion of the associated intrauterine pregnancy. Result: Initial marital disharmony, followed by an uneventful intrauterine pregnancy carried to term with caesarean delivery of a live female baby. Conclusion: In well-selected cases, conservative tubal surgeries should be ...

  5. Glucocorticoid programming of intrauterine development.

    Science.gov (United States)

    Fowden, A L; Valenzuela, O A; Vaughan, O R; Jellyman, J K; Forhead, A J

    2016-07-01

    Glucocorticoids (GCs) are important environmental and maturational signals during intrauterine development. Toward term, the maturational rise in fetal glucocorticoid receptor concentrations decreases fetal growth and induces differentiation of key tissues essential for neonatal survival. When cortisol levels rise earlier in gestation as a result of suboptimal conditions for fetal growth, the switch from tissue accretion to differentiation is initiated prematurely, which alters the phenotype that develops from the genotype inherited at conception. Although this improves the chances of survival should delivery occur, it also has functional consequences for the offspring long after birth. Glucocorticoids are, therefore, also programming signals that permanently alter tissue structure and function during intrauterine development to optimize offspring fitness. However, if the postnatal environmental conditions differ from those signaled in utero, the phenotypical outcome of early-life glucocorticoid receptor overexposure may become maladaptive and lead to physiological dysfunction in the adult. This review focuses on the role of GCs in developmental programming, primarily in farm species. It examines the factors influencing GC bioavailability in utero and the effects that GCs have on the development of fetal tissues and organ systems, both at term and earlier in gestation. It also discusses the windows of susceptibility to GC overexposure in early life together with the molecular mechanisms and long-term consequences of GC programming with particular emphasis on the cardiovascular, metabolic, and endocrine phenotype of the offspring. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Do intrauterine device/intrauterine system users check their threads?

    Science.gov (United States)

    Davies, Amanda; Fleming, Charlotte

    2014-04-01

    Expulsion of an intrauterine device (IUD) occurs in about 1 in 20 women and expulsion may not be noticed by the user. Current guidance recommends that users are instructed to check regularly for their threads. This is the first study to explore the reality of how women feel about checking their threads and the details surrounding how frequently checks are done. One hundred consecutive IUD users were interviewed regarding their type of device, duration of use, frequency of thread checking, prompts for checking and reasons for not checking. Only 23% checked their threads regularly and 51% had never done so. The most common reason for not checking was forgetting about it. Despite being advised to do so, the majority of users do not check their threads at all and fewer than one-quarter of them check regularly. We propose that advice offered about thread checking should be given less emphasis and suggested more for user reassurance.

  7. An unusual case of penetrating head injury in a child

    Directory of Open Access Journals (Sweden)

    Karim Tanweer

    2010-01-01

    Full Text Available Penetrating head injuries can be the result of numerous intentional or unintentional events, including missile wounds, stab wounds, and motor vehicle or occupational accidents (nails, screw-drivers. Penetrating head injuries in children constitute only a small part of the total number of traumatic head injuries seen in casualty. We report a case of neuro-trauma who was operated in our institution. Patient, 4 years male presented in casualty on 15/01/09 with a iron rod penetrating into the skull.

  8. Chinese experience with intrauterine devices.

    Science.gov (United States)

    Bilian, Xiao

    2007-06-01

    Changes in the use of intrauterine devices (IUDs) for contraception in China in the past 10 years are reviewed. Replacement of the inert stainless steel ring with copper-bearing IUDs was an essential decision to improve the efficacy of the IUDs. The most commonly used, TCu380A, TCu220C and MLCu375, and those developed in China, such as the uterine-shaped UCu300 IUD and gamma Cu380 IUD, are reviewed. Studies of MLCu375 and TCu380A for emergency contraception revealed a highly effective method, which could prevent over 96% of unwanted pregnancies. Use of levonorgestrel-releasing system provides both contraceptive and therapeutic effects in the treatment of menorrhagia.

  9. Antenatal risk factor for intrauterine growth restriction

    Directory of Open Access Journals (Sweden)

    N. D. Guliyev

    2015-01-01

    Full Text Available Objective: to study pregnancy and delivery characteristics in mothers who have given birth to infants with intrauterine growth restriction. Pregnancy and delivery outcomes were studied in 315 mothers who had given birth to infants with intrauterine growth restriction (a study group. The studies have shown that toxemia, anemia, and preeclampsia prevent physiological pregnancy that concurrent with placental insufficiency leads to serious metabolic disturbances in the mother-placenta-fetus system and eventually lead to intrauterine growth restriction. A set of pathological factors of pregnancy required surgical delivery in mothers with fetal growth restriction.

  10. Chronic Cervical Perforation by an Intrauterine Device

    Directory of Open Access Journals (Sweden)

    Semra Oruç Koltan

    2010-06-01

    Full Text Available The intrauterine device (IUD is a widely used, highly effective method of birth control. Uterine perforation is a rare yet serious complication and is usually seen during insertion of the IUD. A regular examination is necessary for follow-up. We present a patient with an IUD that had perforated the cervix. The diagnosis was made during routine gynecological examination, and the patient was treated in a timely manner before any complications such as ectopic pregnancy, intrauterine pregnancy, infection or irreversible harm to the cervix arose. This case stresses the importance of regular visits to maintain health and diagnose possible adverse effects of intrauterine contraceptive methods.

  11. Intrauterine neuromuscular blockade in fetus.

    Science.gov (United States)

    Fan, S Z; Huang, F Y; Lin, S Y; Wang, Y P; Hsieh, F J

    1990-03-01

    Antenatal intrauterine fetal therapy has now become the target of numerous invasive diagnostic and therapeutic maneuvers. Fetal motion during intrauterine fetal therapy not only makes these procedures technically more difficult but also increases the likelihood of trauma to the umbilical vessels and the fetus. Combination of high doses of sedatives, tranquilizers, and narcotics rarely results in adequate suppression of fetal movement. Such medication puts the mother at risk of respiratory depression, regurgitation and aspiration. The use of pancuronium or atracurium to temporarily arrest fetal movement in ten fetus is reported. After an initial ultrasound assessment of fetal lie, placental location, and umbilical cord insertion site, the fetal weight was calculated by the ultrasound parameters of biparietal diameter and abdominal circumference. Under ultrasound guidance, we injected pancuronium 0.15 mg/kg or atracurium 1.0 mg/kg using a 23-gauge spinal needle into the fetal gluteal muscle. Short-term paralysis of the fetus was induced in all cases. Fetal movement stopped by sonographic observation within 5.8 +/- 2.3 min in the pancuronium group and 4.7 +/- 1.8 min in the atracurium group. Fetal movements returned both to maternal sensation or ultrasonic observation by 92 +/- 23 min in the first group and 36 +/- 11 min in the second group. No adverse effect of the relaxant has been observed in any of the mothers. There was no evidence of local soft tissue, nerve or muscle damage at the site of injection on initial examination of the neonates after delivery. The use of neuromuscular relaxant in fetus was a safe and useful method.

  12. Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wound: A prospective cohort study.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Tolan, Hüseyin Kerem; Başak, Fatih; Baş, Gürhan; Ünal, Ethem; Alimoğlu, Orhan

    2017-03-01

    Stab wounds in the left thoracoabdominal region may cause diaphragmatic injury. The aim of the present study was to determine incidence of diaphragmatic injury and role of diagnostic laparoscopy in detection of injury in patients with left thoracoabdominal stab wound. Total of 81 patients (75 male, 6 female; mean age 27.5±9.8 years; range 14 to 60 years) who presented with left thoracoabdominal stab wound between April 2009 and September 2014 were evaluated. Laparotomy was performed on patients who had hemodynamic instability, signs of peritonitis, or organ evisceration. Remaining patients were followed conservatively. After 48 hours, diagnostic laparoscopy was performed on patients without laparotomy indication to examine the left diaphragm for injury. Follow-up and treatment findings were prospectively evaluated. Thirteen patients underwent laparotomy while diagnostic laparoscopy was performed on remaining 68 patients. Left diaphragmatic injury was observed in 19 patients (23.5%) in the study group. Four injuries were diagnosed by laparotomy and 15 were diagnosed by laparoscopy. Presence of hemopneumothorax did not yield difference in incidence of diaphragmatic injury (p=0.131). No significant difference was detected in terms of diaphragmatic injury with respect to entry site of stab wound in the thoracoabdominal region (p=0.929). It is important to evaluate the diaphragm in left thoracoabdominal stab injuries, and diagnostic laparoscopy is still the safest and most feasible method.

  13. Cervical spondylodiscitis with epidural abscess after knife stab wounds to the neck: A case report.

    Science.gov (United States)

    Voelker, Anna; von der Hoeh, Nicolas H; Gulow, Jens; Heyde, Christoph-Eckhard

    2015-08-01

    Cervical spondylodiscitis is usually caused by pyogenic infections, associated with retropharyngeal abscesses, or due to the swallowing of foreign bodies. No cases of cervical spondylodiscitis caused by a penetrating neck injury have been published in the literature. We describe a case of cervical spondylodiscitis after multiple knife stab wounds to the lateral soft tissue of the neck. Case report and review of the literature. A 54-year-old patient was brought to our clinic with destructive spondylodiscitis C3/4 with paravertebral and epidural abscesses. He had been involved in a fight and had suffered multiple stab wounds to his neck with a knife 1 month prior. The initial CT scan had revealed one deeper wound canal behind the sternocleidomastoid muscle on the left side without any injury to the vessels. The wound was cleaned and an antibiotic therapy with cefuroxime was given for 1 week. After an uneventful and complete healing of the wound the patient developed severe neck pain. Inflammatory laboratory parameters were elevated, and a MRI of the neck revealed a distinct spondylodiscitis C3/4 with paravertebral and epidural abscess formations. Surgery was performed and included debridement, abscess drainage, decompression of the spinal canal, fusion of the C3/4 segment using an autologous iliac crest bone graft and a plate osteosynthesis. A course of calculated antibiotic therapy was administered for 8 weeks. Normal laboratory parameters and no radiological signs of an ongoing inflammatory process were observed during follow-up examinations. The C3/4 segment was consolidated. Stab wound injuries to the neck not only bear the risk of injuries to the nerves, vessels and organs of the neck but also increase the risk of developing secondary spondylodiscitis. Specifically, cervical spondylodiscitis can result in distinct neurological symptoms, and surgical intervention should be performed in a timely manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Spinal stab injury with retained knife blades: 51 Consecutive patients managed at a regional referral unit.

    Science.gov (United States)

    Enicker, Basil; Gonya, Sonwabile; Hardcastle, Timothy C

    2015-09-01

    Spinal stab wounds presenting with retained knife blades (RKB) are uncommon, often resulting in spinal cord injury (SCI) with catastrophic neurological consequences. The purpose of this study is to report a single unit's experience in management of this pattern of injury at this regional referral centre. Retrospective review of medical records identified 51 consecutive patients with spinal stabs presenting with a RKB at the Neurosurgery Department at Inkosi Albert Luthuli Central Hospital between January 2003 and February 2015. The data was analyzed for patient characteristics, level of the RKB, neurological status using the ASIA impairment scale, associated injuries, radiological investigations, management, hospital length of stay, complications and mortality. The mean age was 28±10.9 years (range 14-69), with 45 (88%) males (M: F=7.5:1). The median Injury Severity Score was 16 (range 4-26). RKB were located in the cervical [9,18%], thoracic [38,74%], lumbar [2,4%] and sacral [2,4%] spine. Twelve patients (24%) sustained complete SCI (ASIA A), while 21 (41%) had incomplete (ASIA B, C, D), of which 17 had features of Brown-Sequard syndrome. Eighteen (35%) patients were neurologically intact (ASIA E). There were 8 (16%) associated pneumothoraces and one vertebral artery injury. Length of hospital stay was 10±7.1 days (range 1-27). One patient (2%) died during this period. Stab injuries to the spine presenting with RKB are still prevalent in South Africa. Resources should be allocated to prevention strategies that decrease the incidence of inter-personal violence. All RKBs should be removed in the operating theatre by experienced surgeons to minimise complications. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Laparoscopic diagnostic peritoneal lavage (L-DPL): A method for evaluation of penetrating abdominal stab wounds.

    Science.gov (United States)

    Krausz, Michael M; Abbou, Benyamine; Hershko, Dan D; Mahajna, Ahmad; Duek, Daniel S; Bishara, Bishara; Israelit, Shlomo H

    2006-03-24

    The management of penetrating abdominal stab wounds has been the subject of continued reappraisal and controversy. In the present study a novel method which combines the use of diagnostic laparoscopy and DPL, termed laparoscopic diagnostic peritoneal lavage (L-DPL) is described Five trauma patients with penetrating injuries to the lower chest or abdomen were included. Standard videoscopic equipment is utilized for the laparoscopic trauma evaluation of the injured patient. When no significant injury is detected, the videoscope is withdrawn and 1000 mL of normal saline is infused through the abdominal trochar into the peritoneal cavity, and the effluent fluid studied for RBCs, WBC, amylase debry, bile as it is uced in regular diagnostic peritoneal lavage Laparoscopic peritoneal lavage (L-DPL) was then performed and proved to be negative in all 5 patients. RBC lavage counts above 100,000/mcrl were not considered as a positive lavage result, because the bleeding source was directly observed and controlled laparoscopically. All patients recovered uneventfully and were released within 3 days. This procedure combines the visual advantages of laparoscopy together with the sensitivity and specificty of DPL for the diagnosis of significant penetrating intra-abdominal injury, when the diagnostic strategy of selective consevatism for abdominal stab wounds is adopted. A method of laparoscopic diagnostic peritoneal lavage (L-DPL) in hemodynamically stable patients with penetrating lower thoracic or abdominal stab wounds is described. The method is especially applicable for trauma surgeons with only basic experience in laparoscopic technique. This procedure is used to obtain conclusive evidence of significant intra-abdominal injury, confirm peritoneal penetration, control intra-abdominal bleeding, and repair lacerations to the diaphragm and abdominal wall. The combination of laparoscopy and DPL afforded by the L-DPL method adds to the sensitivity and specificity of DPL, and

  16. Intrauterine nutritional programming of adult disease

    NARCIS (Netherlands)

    Piersma AH; Siemelink M; Opperhuizen A; LEO

    2001-01-01

    The intrauterine programming hypothesis states that the risk of acquiring diseases in adult life is determined in part by environmental factors during embryofetal development. Especially maternal nutrition has been related to the risk of cancer, cardiovascular disease, diabetes and infectious

  17. Intrauterine growth retardation - small events, big consequences

    Directory of Open Access Journals (Sweden)

    Ali Syed R

    2011-09-01

    Full Text Available Abstract Intrauterine growth retardation refers to a rate of growth of a fetus that is less than normal for the growth potential of a fetus (for that particular gestational age. As one of the leading causes of perinatal mortality and morbidity, intrauterine growth retardation has immense implications for the short term and long term growth of children. It is an important public health concern in the developing countries. Health statistics encompassing parameters for maternal and child health in the Indian subcontinent have shown improvement in the past few years but they are still far from perfect. Maternal health, education and empowerment bears a strong influence on perinatal outcomes including intrauterine growth retardation and should be the primary focus of any stratagem targeted at reducing the incidence of intrauterine growth retardation. A concerted liaison of various medical and social disciplines is imperative in this regard.

  18. Pregnancy outcome in women with an intrauterine contraceptive device.

    Science.gov (United States)

    Ganer, Hadas; Levy, Amalia; Ohel, Iris; Sheiner, Eyal

    2009-10-01

    To investigate pregnancy outcome in patients who conceived with an intrauterine contraceptive device. A retrospective study comparing the pregnancy outcome of women with retained intrauterine device (n = 98), patients after intrauterine device removal in early pregnancy (n = 194), and pregnancies without an intrauterine device (n = 141,191) was performed. A significant linear association was documented among the 3 groups and adverse outcomes such as preterm delivery (18.4% in the retained intrauterine device, 14.4 % in removed intrauterine device, and 7.3% in the no-intrauterine device group; P intrauterine device, 4.1% in removed intrauterine device and 0.7% in the no-intrauterine device group; P intrauterine device was found as an independent risk factor for both preterm delivery and chorioamnionitis in multivariable models. Women conceiving with an intrauterine device are at increased risk for adverse obstetric outcomes, whereas the risk is higher for pregnancies with retained intrauterine device compared with early intrauterine device removal.

  19. Multiple stab wounds: understanding the manner of death through the psychological autopsy.

    Science.gov (United States)

    Di Vella, G; Grattagliano, I; Curti, S; Catanesi, R; Sullivan, M K; Tattoli, L

    2017-01-01

    A 48-year-old physical therapist with no history of psychiatric disorders or suicidal tendencies was found dead by his relatives inside his apartment. Multiple stab wounds were present on the chest and the abdomen. Several more superficial cuts were also seen on the neck and the left wrist. At the death scene, there was a large pool of blood in the room, with secondary droplets and stains; a kitchen knife was found beside the body, and a suicide note on a table. Especially the number of wounds raised strong suspicion of a homicide in the first instance but some circumstances (the farewell letter, the absence of clothing injuries, no signs of third-party involvement) and autopsy findings (absence of defense or blunt injuries, the localization of the wounds, the presence of hesitation marks) pointed toward a suicide etiology. Because of the many stab injuries and the lack of a psychiatric history, further forensic investigations were required including a so-called psychological autopsy. This case report highlights that only a comprehensive interpretation of all the elements (circumstances, the scene of death, autopsy findings, and psychological autopsy) can lead to the correct solution of atypical cases of suicide.

  20. An audit of failed non-operative management of abdominal stab wounds.

    Science.gov (United States)

    Clarke, D L; Allorto, N L; Thomson, S R

    2010-05-01

    Selective non-operative management based on clinical assessment has been shown to be a generally safe approach in the management of penetrating stab wounds of the torso. However there will be a subset of patients who fail selective non-operative management. This audit focuses on the failures. The metropolitan surgical service in Pietermaritzburg covers 3 hospitals. At the weekly metropolitan morbidity and mortality meeting all trauma patients are reviewed. All cases of failed selective non-operative management of penetrating abdominal stab wounds are discussed. Failed non-operative management is usually defined as any patient who ultimately requires surgical exploration. We do not subscribe to this as we feel as long as the need for surgical intervention is recognised within a short period of time (wound were managed over the 2 year period under review. A total of 192 (56%) of these patients were subjected to mandatory laparotomy. Of these mandatory laparotomies 98% were positive. The remaining 148 (44%) patients were observed. Of the 148 observed patients a total of 30 (20%) subsequently underwent surgery. A total of 13 patients were only taken to surgery after 12h of observation. In this group of 13 patients the average delay between admission and recognition of injury was 40 h. There were six gastric injuries, one pyloric and pancreatic injury, two gallbladder injuries, one liver, one colon and two small bowel injuries. There were no deaths. 9 patients recovered with no additional morbidity. In the remainder, morbidity included, relaparotomy (1), open abdomen (1), renal failure (1) and prolonged stay in ICU (3). Clinical assessment accurately predicts the need for mandatory laparotomy following a stab wound to the torso. In patients who do not meet the indications for mandatory laparotomy and who are subjected to non-operative management 20% will come to surgery. A subgroup may only be recognised as requiring surgery after more than 12h. These patients are at

  1. Laparoscopic diagnostic peritoneal lavage (L-DPL: A method for evaluation of penetrating abdominal stab wounds

    Directory of Open Access Journals (Sweden)

    Krausz Michael M

    2006-03-01

    Full Text Available Abstract Background The management of penetrating abdominal stab wounds has been the subject of continued reappraisal and controversy. In the present study a novel method which combines the use of diagnostic laparoscopy and DPL, termed laparoscopic diagnostic peritoneal lavage (L-DPL is described Method Five trauma patients with penetrating injuries to the lower chest or abdomen were included. Standard videoscopic equipment is utilized for the laparoscopic trauma evaluation of the injured patient. When no significant injury is detected, the videoscope is withdrawn and 1000 mL of normal saline is infused through the abdominal trochar into the peritoneal cavity, and the effluent fluid studied for RBCs, WBC, amylase debry, bile as it is uced in regular diagnostic peritoneal lavage Results Laparoscopic peritoneal lavage (L-DPL was then performed and proved to be negative in all 5 patients. RBC lavage counts above 100,000/mcrl were not considered as a positive lavage result, because the bleeding source was directly observed and controlled laparoscopically. All patients recovered uneventfully and were released within 3 days. This procedure combines the visual advantages of laparoscopy together with the sensitivity and specificty of DPL for the diagnosis of significant penetrating intra-abdominal injury, when the diagnostic strategy of selective consevatism for abdominal stab wounds is adopted. Conclusion A method of laparoscopic diagnostic peritoneal lavage (L-DPL in hemodynamically stable patients with penetrating lower thoracic or abdominal stab wounds is described. The method is especially applicable for trauma surgeons with only basic experience in laparoscopic technique. This procedure is used to obtain conclusive evidence of significant intra-abdominal injury, confirm peritoneal penetration, control intra-abdominal bleeding, and repair lacerations to the diaphragm and abdominal wall. The combination of laparoscopy and DPL afforded by the L

  2. Immobilisation versus immediate mobilisation after intrauterine insemination: randomised controlled trial

    NARCIS (Netherlands)

    Custers, Inge M.; Flierman, Paul A.; Maas, Pettie; Cox, Tessa; van Dessel, Thierry J. H. M.; Gerards, Mariette H.; Mochtar, Monique H.; Janssen, Catharina A. H.; van der Veen, Fulco; Mol, Ben Willem J.

    2009-01-01

    Objective To evaluate the effectiveness of 15 minutes of immobilisation versus immediate mobilisation after intrauterine insemination. Design Randomised controlled trial. Setting One academic teaching hospital and six non-academic teaching hospitals. Participants Women having intrauterine

  3. Complications of the intrauterine device in nulliparous and parous women.

    NARCIS (Netherlands)

    Veldhuis, H.M.; Vos, A.G.; Lagro-Janssen, A.L.M.

    2004-01-01

    OBJECTIVES: The intrauterine device (IUD) is still related to pelvic inflammatory disease (PID), pregnancy, expulsion, perforation and menstrual problems, particularly in nulliparous women. We aimed to study the complications and symptoms of the intrauterine device in general practice, particularly

  4. Forgotten intrauterine device contributing to infertility

    Directory of Open Access Journals (Sweden)

    Gabriel O. Igberase

    2011-10-01

    Full Text Available The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out.

  5. Ectopic Intrauterine Device in the Bladder of a Pregnant Woman

    Science.gov (United States)

    Kurdoglu, Zehra; Ceylan, Kadir; Kurdoglu, Mertihan; Guler, Ayse; Sahin, Hanim Guler

    2010-01-01

    Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications. PMID:20811600

  6. A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service.

    Science.gov (United States)

    Madsen, A S; Laing, G L; Bruce, J L; Clarke, D L

    2016-09-01

    Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a 'significant cervical injury' was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed

  7. Intrauterine fertilization capsules--a clinical trial

    DEFF Research Database (Denmark)

    Lenz, S; Lindenberg, S; Sundberg, K

    1991-01-01

    Treatment of 26 women with tubal infertility was attempted using intrauterine capsules loaded with oocytes and spermatozoa. The stimulation protocol was as used for in vitro fertilization and embryo transfer and consisted of short-term use of Buserelin, human menopausal gonadotropin, and human...... and piston from an intrauterine device. Six complete capsules and parts of two other capsules were expelled. None of the women became pregnant, compared with a pregnancy rate of 21% per aspiration following in vitro fertilization and embryo transfer during the same period....

  8. Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

    Directory of Open Access Journals (Sweden)

    Talita Zerbini

    2014-12-01

    Full Text Available Objective: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. Method: Comparison between the findings of different methods: autopsy and postmortem computed tomography. Results: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography. Conclusions: Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations.

  9. Intra-uterine insemination for male subfertility

    NARCIS (Netherlands)

    Bensdorp, A. J.; Cohlen, B. J.; Heineman, M. J.; Vandekerckhove, P.

    2007-01-01

    BACKGROUND: Intra-uterine insemination (IUI) is one of the most frequently used fertility treatments for couples with male subfertility. Its use, especially when combined with ovarian hyperstimulation (OH) has been subject of discussion. Although the treatment itself is less invasive and expensive

  10. Improved reproductive response of sheep in intrauterine ...

    African Journals Online (AJOL)

    Improved reproductive response of sheep in intrauterine insemination program with the use of royal jelly. ... estrus in ewes treated with 100 IU eCG plus 500 mg RJ when compared with the other treatment groups. Keywords: Royal jelly, equine chorionic gonadotropin (eCG), natural progesterone, artificial insemination, ewe ...

  11. Attitudes towards and knowledge about intrauterine contraceptive ...

    African Journals Online (AJOL)

    Background. One of the strategies to reduce maternal mortality includes accessible and appropriate contraceptive services to all women. The intrauterine contraceptive device (IUCD) has been identified as a cheap and effective means of contraception by the South African National Department of Health. Objective.

  12. Prognostic factors affecting outcome of intrauterine insemination ...

    African Journals Online (AJOL)

    Background: There is a recent resurgence in the use of intrauterine insemination (IUI) in Nigeria. However, there is a need for a rational use of the procedure so that couples do not waste time and money on ineffective therapy if it is not indicated. Objective: The objective of this study was to identify the possible prognostic ...

  13. Intra-uterine hematoma in pregnancy

    DEFF Research Database (Denmark)

    Glavind, K; Nøhr, S; Nielsen, P H

    1991-01-01

    In 60 patients with a live fetus and an intra-uterine hematoma (IUH) proven by ultrasonic scanning the outcome of pregnancy was spontaneous abortion in 12% and premature delivery in 10%. No correlation between the outcome of the pregnancy and the maximum size of the hematoma or the week...

  14. Intrauterine Contraceptive Device Discontinuation Among Women in ...

    African Journals Online (AJOL)

    In conclusion, more effort should be directed to counseling for adherence to the IUD use to ensure longer duration of use. Provision of the levonorgestrel intrauterine system which reduces bleeding and dysmenorrhoea, in our clinic may increase the continuation rate of IUD. Key words; IUD, duration of use, discontinuation, ...

  15. Low Cost, Simple, Intrauterine Insemination Procedure with ...

    African Journals Online (AJOL)

    During the last 30 years however, intrauterine insemination has evolved with the introduction of ovulation stimulating protocols and sperm preparation methods taken from assisted reproduction techniques. Costs have risen, but the success rate has not risen to the same extent. We have therefore developed a quite simple ...

  16. Ectopic Pregnancy Coexisting with Intrauterine Pregnancy | Ifenne ...

    African Journals Online (AJOL)

    A pelvic ultrasonography showed a singleton intrauterine pregnancy, a right adnexa mass and fluid in the rectouterine pouch. At laparotomy, a ruptured right ampulary gestation sac and 8 week size uterus were found and a right total salpingectomy done. Postoperative course was uneventful and the patient delivered a live, ...

  17. Case Report - Heterotopic pregnancy following intrauterine ...

    African Journals Online (AJOL)

    She had induction of ovulation with Clomiphene citrate, gonadotropin stimulation (hCG), and intrauterine insemination using donor sperm. The resulting pregnancy ... Presence of corpus luteum cyst of pregnancy in early ultrasound should be an index of suspicious of a possible heterotopic pregnancy. Early diagnosis and ...

  18. Distinguishing intrauterine foetal demise versus abdominal ...

    African Journals Online (AJOL)

    Diagnosis of abdominal pregnancy always poses a clinical dilemma. Transvaginal ultrasound is the ideal radiological procedure in locating these pregnancies. However in resource limited setting, abdominal and pelvic ultrasounds can be the only available yet unreliable modalities for distinguishing intrauterine versus ...

  19. Complications associated with intrauterine contraceptive devices at ...

    African Journals Online (AJOL)

    Background: Intrauterine contraceptive device (IUCD) is one of the reversible methods of contraception. Its use has increased steadily worldwide. However, some women reject it based on presumed complications associated with its use. Aim: To determine the complications reported by women, action taken on the ...

  20. Comparison of genital microbial isolates between intrauterine ...

    African Journals Online (AJOL)

    Background: In the past, the use of intrauterine contraceptive device (IUCD), in particular, Dalkon Shield was found to be associated with increased risk of pelvic infection. Recent literature illustrates that the risk of pelvic infection after insertion of an IUCD is low and that the risk peaks in the 1st month after insertion. We set ...

  1. Cleavage events and sperm dynamics in chick intrauterine embryos.

    Directory of Open Access Journals (Sweden)

    Hyung Chul Lee

    Full Text Available This study was undertaken to elucidate detailed event of early embryogenesis in chicken embryos using a noninvasive egg retrieval technique before oviposition. White Leghorn intrauterine eggs were retrieved from 95 cyclic hens aged up to 54-56 weeks and morphogenetic observation was made under both bright field and fluorescent image in a time course manner. Differing from mammals, asymmetric cleavage to yield preblastodermal cells was observed throughout early embryogenesis. The first two divisions occurred synchronously and four polarized preblastodermal cells resulted after cruciform cleavage. Then, asynchronous cleavage continued in a radial manner and overall cell size in the initial cleavage region was smaller than that in the distal area. Numerous sperms were visible, regardless of zygotic nuclei formation. Condensed sperm heads were present mainly in the perivitelline space and cytoplasm, and rarely in the yolk region, while decondensed sperm heads were only visible in the yolk. In conclusion, apparent differences in sperm dynamics and early cleavage events compared with mammalian embryos were detected in chick embryo development, which demonstrated polarized cleavage with penetrating supernumerary sperm into multiple regions.

  2. 19th Biannual Symposium of the German Aerospace Aerodynamics Association (STAB) and the German Society for Aeronautics and Astronautics (DGLR)

    CERN Document Server

    Heller, Gerd; Krämer, Ewald; Wagner, Claus; Breitsamter, Christian

    2016-01-01

    This book presents contributions to the 19th biannual symposium of the German Aerospace Aerodynamics Association (STAB) and the German Society for Aeronautics and Astronautics (DGLR). The individual chapters reflect ongoing research conducted by the STAB members in the field of numerical and experimental fluid mechanics and aerodynamics, mainly for (but not limited to) aerospace applications, and cover both nationally and EC-funded projects. Special emphasis is given to collaborative research projects conducted by German scientists and engineers from universities, research-establishments and industries. By addressing a number of cutting-edge applications, together with the relevant physical and mathematics fundamentals, the book provides readers with a comprehensive overview of the current research work in the field. Though the book’s primary emphasis is on the aerospace context, it also addresses further important applications, e.g. in ground transportation and energy. .

  3. Multiple self-inflicted stab wounds to neck, chest and abdomen as a unique manner of suicide.

    Science.gov (United States)

    Kaliszan, Michał; Kernbach-Wighton, Gerhard; Bouhaidar, Ralph

    2010-05-01

    This is a case report of a 30-year-old man found dead in his flat lying on the floor with multiple stab wounds over the body, surrounded by an extensive volume of blood. Examination of the scene of death showed a secure flat, locked from inside. A blood-stained knife was present close to the body and two unstained notes left on the sofa at the locus. A small plastic bag containing white powder (which following toxicological examinations appeared to be cocaine) and an almost full bottle of beer were present on a table. Autopsy revealed more than 40 stab wounds to neck, chest, and abdomen arranged in isolated groups within which the wounds showed similar directions and had a transverse orientation. Together with hesitation marks located on the neck and wrists these characteristics allowed to interpret this case as a suicide.

  4. The direct cost of traumatic secretion transfer in hermaphroditic land snails: individuals stabbed with a love dart decrease lifetime fecundity

    OpenAIRE

    Kimura, Kazuki; Chiba, Satoshi

    2015-01-01

    Several taxa of simultaneously hermaphroditic land snails exhibit a conspicuous mating behaviour, the so-called shooting of love darts. During mating, such land snail species transfer a specific secretion by stabbing a mating partner's body with the love dart. It has been shown that sperm donors benefit from this traumatic secretion transfer, because the secretions manipulate the physiology of a sperm recipient and increase the donors' fertilization success. However, it is unclear whether rec...

  5. Comparison between isolated serial clinical examination and computed tomography for stab wounds in the anterior abdominal wall.

    Science.gov (United States)

    Breigeiron, Ricardo; Breitenbach, Tiago Cataldo; Zanini, Lucas Adalberto Geraldi; Corso, Carlos Otavio

    2017-01-01

    to compare abdominal computer tomography (CT) with isolated serial clinical exam (SCE) in the management of anterior abdominal stab wounds. randomized prospective study performed at Hospital de Pronto Socorro de Porto Alegre involving patients with anterior abdominal stab wounds without indication of immediate laparotomy; patients were divided in two groups: CT group and SCE group, In the SCE group, patients were followed up with serial clinical exam every 6 hours, Patients of CT group were submitted to abdominal computer tomography after initial evaluation. 66 patients were studied and 33 were included in each group, Of total, six were submitted to surgery, three of each group, In the SCE group, patients submitted to surgery in media waited 12 hours from arrival to diagnosis without any non-therapeutic surgeries, The remaining 30 patients of this group were discharged from hospital after 24 hours of observation, In the CT group, three patients showed alteration at CT and were submitted to laparotomy, one non-therapeutic, The others were discharged from hospital after 24 hours of observation, Abdominal computer tomography had a positive predictive value (PPV) of 67% and negative predictive value (NPV) of 100%, with 96% of accuracy, Isolated serial clinical exam showed PPV and NPV of 100% and 100% of accuracy. selective management of anterior abdominal stabs is safe, when a rigorous selection of patients is observed, Isolated serial clinical exam may be performed without computer tomography, without increase of hospitalization time or morbidity, reducing costs, exposure to radiation, mortality and morbidity and non-therapeutic laparotomies.

  6. Misplaced intrauterine contraceptive device: an enigma

    OpenAIRE

    Aruna Nigam; Ratna Biswas; Archana Mishra

    2010-01-01

    Aruna Nigam, Ratna Biswas, Archana MishraDepartment of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, IndiaAbstract: Intrauterine contraceptive device (IUCD) migration subsequent to uterine wall perforation is an uncommon but serious complication. Three cases of misplaced IUCD at three different sites, ie, posterior fornix, rectal wall, and mesoappendix, are reported. An IUCD thread coming through the posterior fornix is reported in the literature for the first time.Key...

  7. Intrauterine supraventricular tachyarrhythmias and transplacental digitalisation.

    OpenAIRE

    Nagashima, M; Asai, T; Suzuki, C; Matsushima, M; Ogawa, A

    1986-01-01

    Six newborn infants with intrauterine supraventricular tachyarrhythmias (five cases of atrial flutter and one of supraventricular tachycardia) are described. Transplacental digitalisation was attempted in three cases. Supraventricular tachycardia associated with hydrops fetalis, detected in a fetus at a gestation of 31 weeks, was successfully converted to normal sinus rhythm eight days after the mother began treatment with digoxin. The serum concentration of digoxin in cord blood almost equal...

  8. A new method of ergonomic testing of gloves protecting against cuts and stabs during knife use.

    Science.gov (United States)

    Irzmańska, Emilia; Tokarski, Tomasz

    2017-05-01

    The paper presents a new method of ergonomic evaluation of gloves protecting against cuts and stabs during knife use, consisting of five manual dexterity tests. Two of them were selected based on the available literature and relevant safety standards, and three were developed by the authors. All of the tests were designed to simulate occupational tasks associated with meat processing as performed by the gloved hand in actual workplaces. The tests involved the three most common types of protective gloves (knitted gloves made of a coverspun yarn, metal mesh gloves, and metal mesh gloves with an ergonomic polyurethane tightener) and were conducted on a group of 20 males. The loading on the muscles of the upper limb (adductor pollicis, flexor carpi ulnaris, flexor carpi radialis, and biceps brachii) was measured using surface electromyography. For the obtained muscle activity values, correlations were found between the glove type and loading of the upper limb. ANOVA showed that the activity of all muscles differed significantly between the five tests. A relationship between glove types and electromyographic results was confirmed at a significance level of α = 0.05. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. [Forensic medical expertise of the stab wounds: the current state-of-the art].

    Science.gov (United States)

    Sarkisian, B A; Karpov, D A

    2014-01-01

    This review of special literature encompasses the publications on the injuries inflicted by piercing objects. The results of analysis of these materials indicate that both the mechanisms of formation and the morphological features of stab wounds and damages to the clothes are studied perfectly well. Their shape and morphological patterns are shown to be dependent on the size, shape, and cross-section area of the great variety of the piercing objects. However, investigations carried out thus far did not take into consideration the formation of the signs of skin plastic deformation, such as edge portions of borderline thickening, stretching of epidermis over the walls, transformation of the epidermal network pattern into longitudinal folding, etc. It is concluded that further studies are necessary to better characterize injuries inflicted by piercing objects differing in the sharpness and the shape of cross section and thereby to obtain a deeper insight in the morphological features. It can be expected that such studies will provide a basis for the development of criteria for the individual and intra-group expert identification of the traumatic agents.

  10. The spectrum of injuries resulting from posterior abdominal stab wounds: a South African experience.

    Science.gov (United States)

    Kong, V Y; Oosthuizen, G V; Clarke, D L

    2015-05-01

    The spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature on the spectrum of organ injury associated with SWs to the posterior abdomen, however, is limited. We reviewed our experience of 105 consecutive patients who had established indications for laparotomy managed over a 4-year period in a high volume trauma service in South Africa. Of the 105 patients, 97 (92%) were male and the overall mean age was 24 years. Fifty-seven patients (54%) had immediate indications for laparotomy. The remaining 48 patients (46%) initially underwent active clinical observation and the indications for laparotomy became apparent during the observation period. Of the 105 laparotomies performed, 94 (90%) were positive and 11 (10%) were negative. Of the 94 positive laparotomies, 92 were therapeutic and 2 were non-therapeutic. A total of 176 organ injuries were identified: 50 (53%) of the 94 patients sustained a single organ injury while the remaining 44 (47%) sustained multiple organ injuries. The most commonly injured organs were the colon (n=63), spleen (n=21) and kidney (n=19). The pattern of intra-abdominal injuries secondary to SWs to the posterior abdomen is different to that seen with the anterior abdomen. Colonic injury is most commonly encountered, followed by injuries to the spleen and kidney. Clinicians must remain vigilant because of the potential for occult injuries.

  11. Determining injuries from posterior and flank stab wounds using computed tomography tractography.

    Science.gov (United States)

    Bansal, Vishal; Reid, Chris M; Fortlage, Dale; Lee, Jeanne; Kobayashi, Leslie; Doucet, Jay; Coimbra, Raul

    2014-04-01

    Unlike anterior stab wounds (SW), in which local exploration may direct management, posterior SW can be challenging to evaluate. Traditional triple contrast computed tomography (CT) imaging is cumbersome and technician-dependent. The present study examines the role of CT tractography as a strategy to manage select patients with back and flank SW. Hemodynamically stable patients with back and flank SW were studied. After resuscitation, Betadine- or Visipaque®-soaked sterile sponges were inserted into each SW for the estimated depth of the wound. Patients underwent abdominal helical CT scanning, including intravenous contrast, as the sole abdominal imaging study. Images were reviewed by an attending radiologist and trauma surgeon. The tractogram was evaluated to determine SW trajectory and injury to intra- or retroperitoneal organs, vascular structures, the diaphragm, and the urinary tract. Complete patient demographics including operative management and injuries were collected. Forty-one patients underwent CT tractography. In 11 patients, tractography detected violation of the intra- or retroperitoneal cavity leading to operative exploration. Injuries detected included: the spleen (two), colon (one), colonic mesentery (one), kidney (kidney), diaphragm (kidney), pneumothorax (seven), hemothorax (two), iliac artery (one), and traumatic abdominal wall hernia (two). In all patients, none had negative CT findings that failed observation. In this series, CT tractography is a safe and effective imaging strategy to evaluate posterior torso SW. It is unknown whether CT tractography is superior to traditional imaging modalities. Other uses for CT tractography may include determining trajectory from missile wounds and tangential penetrating injuries.

  12. INTRAUTERINE FETAL DEATH CASES AT TERTIARY CENTER

    Directory of Open Access Journals (Sweden)

    Babu Lal Bishnoi

    2018-01-01

    Full Text Available BACKGROUND Intrauterine fetal death is a tragic event for the parents and a great cause of stress for the caregiver. It is an important indicator of maternal and perinatal health of a given population. This study was undertaken to study the maternal and fetal factors associated with intrauterine fetal death. Aim and Objective- This was an Analytical study aimed to evaluate and understand the prevalence, socio-epidemiological and etiological factors of IUFD methodology should not be mixed with aims and objectives MATERIALS AND METHODS The study was carried out at March 2017 to June 2017 (4 months study which was conducted at Dr. S. N. Medical College, Jodhpur, Rajasthan. The details were entered in a preformed proforma. IUD is defined as fetal death beyond 20 weeks of gestation and/or birth weight >500g. The details of complaints at admission, obstetrics history, menstrual history, examination findings, per vaginal examination findings, mode and method of delivery and fetal outcomes and investigation reports were recorded. RESULTS A total of 227 intrauterine fetal deaths were reported amongst 6264 deliveries conducted during the study period. The incidence rate of intrauterine fetal death was 36/1000 live births. 192 (84.56% deliveries were unbooked and unsupervised and 133 (58.59% belonged to rural population and 126 (55.5% were preterm and 221 (97.55% were singleton pregnancy. Among the identifiable causes hypertensive disorders (24.22% and severe anemia (13.10% were most common followed by placental causes (9.97%. Congenital malformations were responsible for 12.39% and unidentifiable causes were 11.01%. Induction was done in 103 patients, 94 patients had spontaneous onset of labour and caesarean section was done in 30 patients. Incidence of intrauterine foetal demise gradually decreased as parity advanced. CONCLUSION Institutional deliveries should be promoted to prevent intrapartum fetal deaths. Decrease in the incidence of IUD would

  13. A suspicious reason for Raynaud's phenomenon: Intrauterine device.

    Science.gov (United States)

    Diken, Adem I; Yalçınkaya, Adnan; Aksoy, Eray; Yılmaz, Seyhan; Çağlı, Kerim

    2015-06-01

    Primary Raynaud's phenomenon may be insistent in patients under medical therapy, and intrauterine devices may be an unnoticed reason in these patients. Fluctuations in female sex hormone status were reported to be associated with the emergence of primary Raynaud's phenomenon symptoms. The use of intrauterine devices was not reported to be associated with Raynaud's phenomenon previously. Intrauterine device may stimulate vascular hyperactivity regarding hormonal or unknown mechanisms that result in Raynaud's phenomenon. We present a postmenopausal patient who complained of primary Raynaud's phenomenon symptoms and had recovery after the removal of her copper intrauterine device. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Ectopic Intrauterine Device in the Bladder of a Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Zehra Kurdoglu

    2010-01-01

    Full Text Available Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.

  15. NG2 cells are not a major source of reactive astrocytes after neocortical stab wound injury.

    Science.gov (United States)

    Komitova, Mila; Serwanski, David R; Lu, Q Richard; Nishiyama, Akiko

    2011-05-01

    NG2 cells are an abundant glial cell type in the adult brain. They are distinct from astrocytes, mature oligodendrocytes, and microglia. NG2 cells generate oligodendrocytes and a subpopulation of protoplasmic astrocytes in the ventral forebrain during development. To determine whether NG2 cells generate reactive astrocytes in the lesioned brain, stab wound injury was created in adult NG2creBAC:ZEG double transgenic mice, in which enhanced green fluorescent protein (EGFP) is expressed in NG2 cells and their progeny, and the phenotype of the EGFP(+) cells was analyzed at 10 and 30 days post lesion (dpl). The majority (>90%) of the reactive astrocytes surrounding the lesion that expressed glial fibrillary acidic protein (GFAP) lacked EGFP expression, and conversely the majority (>90%) of EGFP(+) cells were GFAP-negative. However, 8% of EGFP(+) cells co-expressed GFAP at 10 dpl. Most of these EGFP(+) GFAP(+) cells were morphologically distinct from hypertrophic reactive astrocytes and exhibited weak GFAP expression. NG2 was detected in a fraction of the EGFP(+) GFAP(+) cells found at 10 dpl. By 30 dpl the number of EGFP(+) GFAP(+) cells had decreased more than four-fold from 10 dpl. A similar transient appearance of EGFP(+) GFAP(+) cells with simple morphology was observed in NG2creER™:ZEG double transgenic mice in which EGFP expression had been induced in NG2 cells prior to injury. NG2 cell-specific deletion of the oligodendrocyte lineage transcription factor Olig2 using NG2creER™:Olig2(fl/fl) :ZEG triple transgenic mice did not increase the number of EGFP(+) reactive astrocytes. These findings suggest that NG2 cells are not a major source of reactive astrocytes in the neocortex. Copyright © 2011 Wiley-Liss, Inc.

  16. Head Lice

    Science.gov (United States)

    Head lice are parasitic wingless insects. They live on people's heads and feed on their blood. An adult louse ... Children ages 3-11 and their families get head lice most often. Personal hygiene has nothing to ...

  17. Glucocorticoids as regulatory signals during intrauterine development.

    Science.gov (United States)

    Fowden, Abigail L; Forhead, Alison J

    2015-12-01

    What is the topic of this review? This review discusses the role of the glucocorticoids as regulatory signals during intrauterine development. It examines the functional significance of these hormones as maturational, environmental and programming signals in determining offspring phenotype. What advances does it highlight? It focuses on the extensive nature of the regulatory actions of these hormones. It highlights the emerging data that these actions are mediated, in part, by the placenta, other endocrine systems and epigenetic modifications of the genome. Glucocorticoids are important regulatory signals during intrauterine development. They act as maturational, environmental and programming signals that modify the developing phenotype to optimize offspring viability and fitness. They affect development of a wide range of fetal tissues by inducing changes in cellular expression of structural, transport and signalling proteins, which have widespread functional consequences at the whole organ and systems levels. Glucocorticoids, therefore, activate many of the physiological systems that have little function in utero but are vital at birth to replace the respiratory, nutritive and excretory functions previously carried out by the placenta. However, by switching tissues from accretion to differentiation, early glucocorticoid overexposure in response to adverse conditions can programme fetal development with longer term physiological consequences for the adult offspring, which can extend to the next generation. The developmental effects of the glucocorticoids can be direct on fetal tissues with glucocorticoid receptors or mediated by changes in placental function or other endocrine systems. At the molecular level, glucocorticoids can act directly on gene transcription via their receptors or indirectly by epigenetic modifications of the genome. In this review, we examine the role and functional significance of glucocorticoids as regulatory signals during intrauterine

  18. Intrauterine supraventricular tachyarrhythmias and transplacental digitalisation.

    Science.gov (United States)

    Nagashima, M; Asai, T; Suzuki, C; Matsushima, M; Ogawa, A

    1986-10-01

    Six newborn infants with intrauterine supraventricular tachyarrhythmias (five cases of atrial flutter and one of supraventricular tachycardia) are described. Transplacental digitalisation was attempted in three cases. Supraventricular tachycardia associated with hydrops fetalis, detected in a fetus at a gestation of 31 weeks, was successfully converted to normal sinus rhythm eight days after the mother began treatment with digoxin. The serum concentration of digoxin in cord blood almost equalled the maternal concentration in three cases. In the remaining three cases treatment with digitalis was effective in converting tachyarrhythmias to sinus rhythm after delivery. With maintenance digoxin therapy, the prognosis of fetal tachyarrhythmias seems to be good, once conversion to sinus rhythm has been accomplished.

  19. Immediate Intrauterine Device Insertion Following Surgical Abortion.

    Science.gov (United States)

    Patil, Eva; Bednarek, Paula H

    2015-12-01

    Placement of an intrauterine device (IUD) immediately after a first or second trimester surgical abortion is safe and convenient and decreases the risk of repeat unintended pregnancy. Immediate postabortion IUD placement is not recommended in the setting of postprocedure hemorrhage, uterine perforation, infection, or hematometra. Otherwise, there are few contraindications to IUD placement following surgical abortion. Sexually transmitted infection screening should follow US Centers for Disease Control and Prevention guidelines. No additional antibiotics are needed beyond those used for the abortion. Placing immediate postabortion IUDs makes highly-effective long-acting reversible contraception more accessible to women. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Intussusception is a known complication of Meckel's diverticulum. However, intrauterine intussusception secondary to Meckel's diverticulum has unknown incidence. Our case describes the medical and surgical management of a newborn with intrauterine intussusception of a Meckel's diverticulum as a cause of the vascular ...

  1. 21 CFR 529.1044a - Gentamicin sulfate intrauterine solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin sulfate intrauterine solution. 529.1044a Section 529.1044a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... § 529.1044a Gentamicin sulfate intrauterine solution. (a) Specifications. Each milliliter of solution...

  2. 21 CFR 529.50 - Amikacin sulfate intrauterine solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Amikacin sulfate intrauterine solution. 529.50 Section 529.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Amikacin sulfate intrauterine solution. (a) Specifications. Each milliliter of sterile aqueous solution...

  3. Consequences of intrauterine growth restriction for the kidney

    NARCIS (Netherlands)

    M.F. Schreuder; A. van Wijk (Ans); H.A. Delemarre-van de Waal (Henriette)

    2006-01-01

    textabstractLow birth weight due to intrauterine growth restriction is associated with various diseases in adulthood, such as hypertension, cardiovascular disease, insulin resistance and end-stage renal disease. The purpose of this review is to describe the effects of intrauterine growth restriction

  4. Intrauterine insemination versus intracervical insemination in donor sperm treatment

    NARCIS (Netherlands)

    Kop, Petronella Al; Mochtar, Monique H.; O'Brien, Paul A.; van der Veen, Fulco; van Wely, Madelon

    2018-01-01

    The first-line treatment in donor sperm treatment consists of inseminations that can be done by intrauterine insemination (IUI) or by intracervical insemination (ICI). To compare the effectiveness and safety of intrauterine insemination (IUI) and intracervical insemination (ICI) in women who start

  5. Immediate postpartum versus 6-week postpartum intrauterine device ...

    African Journals Online (AJOL)

    This study aimed to evaluate the feasibility of conducting a randomized controlled trial of postpartum intrauterine device insertion and to demonstrate that the postpartum intrauterine device is acceptable to women. Women attending prenatal care at a maternity hospital in Lilongwe, Malawi were recruited into a trial ...

  6. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Vesical Calculus 10 Years Post Missing Intrauterine. Contraceptive Device. Abdullahi Abdulwahab-Ahmed, Oluwagbemiga Olabisi Ogunleye. INTRODUCTION. Intrauterine contraceptive devices (IUCD) are acceptable means of contraception world over.[1-4] There have been reports of its migration to other adjourning sites ...

  7. Cardiovascular adaptation to extrauterine life after intrauterine growth restriction.

    Science.gov (United States)

    Rodriguez-Guerineau, Luciana; Perez-Cruz, Miriam; Gomez Roig, María D; Cambra, Francisco J; Carretero, Juan; Prada, Fredy; Gómez, Olga; Crispi, Fátima; Bartrons, Joaquim

    2018-02-01

    Introduction The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth. A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates. Compared with controls, neonates with intrauterine growth restriction had more globular ventricles, lower longitudinal tricuspid annular motion, and higher left stroke volume without differences in the heart rate. Neonates with intrauterine growth restriction also showed subclinical signs of diastolic dysfunction in the tissue Doppler imaging with lower values of early (e') diastolic annular peak velocities in the septal annulus. Finally, the Tei index in the tricuspid annulus was higher in the intrauterine growth restriction group. Neonates with history of intrauterine growth restriction showed cardiac remodelling and signs of systolic and diastolic dysfunction. Overall, there was a significant tendency to worse cardiac function results in the right heart. The adaptation to extrauterine life occurred with more globular hearts, higher stroke volumes but a similar heart rate compared to adequate-for-gestational-age neonates.

  8. Intrauterine fetal death and risk of shoulder dystocia at delivery.

    Science.gov (United States)

    Larsen, Sandra; Dobbin, Joanna; McCallion, Oliver; Eskild, Anne

    2016-12-01

    Vaginal delivery is recommended after intrauterine fetal death. However, little is known about the risk of shoulder dystocia in these deliveries. We studied whether intrauterine fetal death increases the risk of shoulder dystocia at delivery. In this population-based register study using the Medical Birth Registry of Norway, we included all singleton pregnancies with vaginal delivery of offspring in cephalic presentation in Norway during the period 1967-2012 (n = 2 266 118). Risk of shoulder dystocia was estimated as absolute risk (%) and odds ratio with 95% confidence interval. Adjustment was made for offspring birthweight (in grams). We performed sub-analyses within categories of birthweight (Shoulder dystocia occurred in 1.1% of pregnancies with intrauterine fetal death and in 0.8% of pregnancies without intrauterine fetal death (p shoulder dystocia occurred in 14.6% of pregnancies with intrauterine fetal death and in 2.8% of pregnancies without intrauterine fetal death (p shoulder dystocia occurred in 57.1% of pregnancies with intrauterine fetal death and 9.6% of pregnancies without intrauterine fetal death (p shoulder dystocia at delivery, and the absolute risk of shoulder dystocia was particularly high if offspring birthweight was high and the mother had diabetes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Thermally Bonded PET–Basalt Sandwich Composites for Heat Pipeline Protection: Preparation, Stab Resisting, and Thermal-Insulating Properties

    Directory of Open Access Journals (Sweden)

    Ting-Ting Li

    2018-03-01

    Full Text Available In order to solve the cost and bulky problems of buried thermal pipeline insulating materials, this study adopts basalt fabric and low-melting PET nonwoven to construct low-cost and light-weight pipeline thermal-insulating composites after needle punching and thermal bonding processes. Research result shows that thermal-bonded temperature affected the stab resistance and burst energy more significantly. As thermal-bonded temperature increased, knife resistance and spike resistance presented the upward and then downward trends, but the burst energy gradually decreased. Yarn pull-out result shows that the enhancement of stab resistance of intra-/inter-thermal-bonded structure resulted from the increment in the coefficient of friction between yarns. When PET–basalt sandwich composites were thermal-bonded at 140 °C for 5 min, the maximum knife and spike resistance were 147.00 N (1.99 J and 196.30 N (1.11 J, respectively, and burst energy was 4.79 J, thermal conductivity reduced to 0.0073 W/(m∙K. The resultant thermally bonded sandwich composites can be used as thermal-insulating protection for buried thermal pipeline.

  10. Penetrating Stab Injuries to the Anterior Abdomen: Use of Multi-Detector Computed Tomography to Predict the Need for Laparotomy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dae Hong; Choi, Seung Joon; Jeong, Yu Mi; Kim, Hyung Sik; Choi, Hye Young [Dept. of Radiology, Gachon University, Gil Hospital, Incheon (Korea, Republic of)

    2013-01-15

    The aim of this study was to determine how well multi-detector computed tomography (MDCT) scans predict the need for a laparotomy in patients with anterior abdominal stab injuries. Eighty patients with abdominal stab injuries who underwent MDCT scans were enrolled. MDCT was performed to identify active bleeding and injured organs and to assess the accuracy between MDCT and the laparotomy findings. MDCT was considered positive or negative with respect to the need for an exploratory laparotomy. The diagnostic performance of MDCT for identifying the need for laparotomy was estimated. MDCT predicted bowel and mesentery injuries in 31 of 80 patients and 28 patients were truly positive. MDCT predicted active bleeding in 23 of 80 patients and 19 patients had active bleeding. MDCT predicted the need for laparotomy in 43 of 80 patients. A laparotomy was performed in 55 of the 80 patients and 42 were therapeutic. Overall, a MDCT scan predicted the need for laparotomy with 95% sensitivity, 92% specificity, and 93% accuracy. MDCT scans can be used to identify active bleeding and injured organs and are an effective tool for determining the need for surgical exploration.

  11. Fatal tiger attack: a case report with emphasis on typical tiger injuries characterized by partially resembling stab-like wounds.

    Science.gov (United States)

    Pathak, Hrishikesh; Borkar, Jaydeo; Dixit, Pradeep; Dhawane, Shailendra; Shrigiriwar, Manish; Dingre, Niraj

    2013-10-10

    Fatalities due to attacks by tigers on humans are uncommon and are rarely described in the medico-legal literature. We herein present a forensic investigation in a unique case of a fatal tiger attack in the wild on a 35 year old female in India by an Indian Bengal tiger (Panthera tigris tigris). The attack resulted in two pairs of puncture wounds over the nape area with occult cervical spine injuries resulting from transfixing of spine due to the tiger canines; multiple puncture wounds, numerous scratches and abrasions consistent with the tiger claw injuries and injury to the right jugulocarotid vessels. This case outlines the characteristic injury pattern from such an attack along with the multiple sources of the tiger injuries. The analysis of these injuries might reveal the motivation behind the attack and the big cat species involved in the attack. A tiger injury is sometimes compared with a stab injury, as the patterned injuries due to a tiger bite are characterized by multiple penetrating, stab-like wounds. So, a special attention is paid toward establishment of the cause of death from bites by the animal teeth under unknown circumstances of trauma and to exclude the possibility of a homicide beyond reasonable doubt in such cases. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Comparison of copper intrauterine device with levonorgestrel-bearing intrauterine system for post-abortion contraception.

    Science.gov (United States)

    Bilgehan, Fatma; Dilbaz, Berna; Karadag, Burak; Deveci, Canan Dura

    2015-09-01

    The aim of this study was to compare the safety, bleeding pattern, effects, side-effects, complications and 6-month continuity rates of levonorgestrel-bearing intrauterine system (LNG-IUS) with conventional copper intrauterine device (Cu-IUD) inserted immediately after voluntary termination of pregnancy up to 10 weeks of gestation. One hundred women who underwent voluntary pregnancy termination and preferred IUD insertion as a contraceptive method after counseling were enrolled. The patients were randomly allocated to Cu-IUD or LNG-IUS and followed up at 10 days, and at 1, 3 and 6 months. The expulsion rates, continuation rates, side-effects, and bleeding patterns were compared. Fifty women in the Cu-IUD group and 44 women in the LNG-IUS group were followed up. The continuity and expulsion rate for Cu-IUD and LNG-IUS at the end of 6 months was 74%, 12%, and 75%, 11.3%, respectively. In LNG-IUS users, the incidence of amenorrhea and the number of spotting days were higher and hemoglobin increased throughout the follow-up period. The side-effects related to both methods were not different from interval insertions. Immediate post-abortion intrauterine contraception with Cu-IUD or LNG-IUS is a safe, reliable method. The incidence of side-effects is similar, and there is only a slightly higher rate of expulsion but an acceptable rate of method continuation. © 2015 Japan Society of Obstetrics and Gynecology.

  13. Intrauterine photoacoustic and ultrasound imaging probe.

    Science.gov (United States)

    Miranda, Christopher; Barkley, Joel; Smith, Barbara

    2018-04-01

    Intrauterine photoacoustic and ultrasound imaging are probe-based imaging modalities with translational potential for use in detecting endometrial diseases. This deep-tissue imaging probe design allows for the retrofitting of commercially available endometrial sampling curettes. The imaging probe presented here has a 2.92-mm diameter and approximate length of 26 cm, which allows for entry into the human endometrial cavity, making it possible to use photoacoustic imaging and high-resolution ultrasound to characterize the uterus. We demonstrate the imaging probes' ability to provide structural information of an excised pig uterus using ultrasound imaging and detect photoacoustic signals at a radial depth of 1 cm. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  14. Vesical transmigration of an intrauterine contraceptive device

    Science.gov (United States)

    Chai, Wei; Zhang, Wenlei; Jia, Guifeng; Cui, Miao; Cui, Lifeng

    2017-01-01

    Abstract Rationale: Displacement of an intrauterine contraceptive device (IUD) is a rare and serious complication of IUD insertion. Theoretically, it can migrate to anywhere in the pelvic and abdominal cavity. However, it is not usual for an IUD to migrate to the bladder. Patient concerns: In this case report, we reported a patient with chronic urinary symptoms caused by the migration of an IUD into the bladder. The displacement of the IUD led to contraception failure and IUD retention in the bladder for 5 years. Diagnoses: Pelvic ultrasonography (US), radiography, and cystoscopy examinations confirmed the migration of IUD in bladder. Interventions: The patient underwent cystoscopy. Outcomes: The MCu IUD was successfully removed without any complications. Lessons: Our study demonstrated that a missing IUD should be followed up and removed early to avoid possible serious complications. PMID:28984781

  15. The intrauterine device: dispelling the myths.

    Science.gov (United States)

    Kimble-Haas, S L

    1998-11-01

    The worldwide popularity and usage of intrauterine devices (IUDs) plummeted in the 1970s, when grim reports of septic abortions and pelvic inflammatory disease were published. Although the Dalkon Shield ultimately was determined to be the culprit for these problems, the reputation of all IUDs was damaged, and their popularity spiraled downward. The stigma continues, despite the proven safety and efficacy of newer IUDs, particularly the ParaGard T 380A and the Progestasert, which are now the only two IUDs approved for use in the United States. This article will review how the IUD works and will focus on dispelling the misconceptions surrounding its use. Rigid patient-selection guidelines and strict aseptic insertion techniques can provide safe, long-term, cost-effective, and highly efficacious contraception for monogamous women. Practitioners who follow these guidelines should not fear prescribing IUDs as a contraceptive device in the appropriate female population.

  16. Investigation of knowledge level about intrauterine device

    Directory of Open Access Journals (Sweden)

    Hediye Dagdeviren

    2013-06-01

    Full Text Available Objective: To investigate a level of knowledge about intrauterine device between females who were examined in our gynecology department. Metods: The study was conducted at Gynecology and Obstetric Department of Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital between August 2012-November 2012. The study were included 189 patients who accepted to participate. For collecting data; a form of questionnaire was used which has gived information about the intrauterine device (IUD and status of socio-demographic characteristics of the patients. The questionnaire were administered by the researchers in a separate room as a face-to-face interviews. SPSS 20.0 (SPSS Inc, Chicago, IL, USA program was used for statistical analysis. Results: The mean age of the women in the study was 31.1 ± 9.9. 44.7% of women were not using any modern contraceptive method. IUD utilization rate was 3.2%. 1.6% of women had never heard IUD, %76.1 women heard copper IUD. 42% of respondents gave the wrong answer to IUD inserted into ovaries. Conclusion: The IUD which is a cheap, does not require patient compliance, and has high efficacy. In this study, we were not found a statisfically significant difference for answers to questions in patients with different socio-demographic characteristics. The main result of the study was; among all parcipitians ,even health care workers there was an important disability about level of knowledge for IUD. It is great importance the whole society, including health professionals must train about family planning. [Cukurova Med J 2013; 38(3.000: 440-445

  17. Heads Up

    Science.gov (United States)

    ... Form Controls Cancel Submit Search the CDC HEADS UP Note: Javascript is disabled or is not supported ... please visit this page: About CDC.gov . HEADS UP Brain Injury Basics What Is a Concussion? Concussion ...

  18. A comparison of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of adhesion reformation following hysteroscopic surgery for Asherman syndrome: a cohort study.

    Science.gov (United States)

    Lin, Xiaona; Wei, Minling; Li, T C; Huang, Qiongxiao; Huang, Dong; Zhou, Feng; Zhang, Songying

    2013-10-01

    To compare the efficacy of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of the adhesion reformation after hysteroscopic adhesiolysis for Asherman's syndrome. Retrospective cohort study of 107 women with Asherman's syndrome who were treated with hysteroscopic division of intrauterine adhesions. After hysteroscopic adhesiolysis, 20 patients had intrauterine balloon inserted, 28 patients had intrauterine contraceptive device (IUD) fitted, 18 patients had hyaluronic acid gel instilled into the uterine cavity, and 41 control subjects did not have any of the three additional treatment measures. A second-look hysteroscopy was performed in all cases, and the effect of hysteroscopic adhesiolysis was scored by the American Fertility Society classification system. Both the intrauterine balloon group and the IUD group achieved significantly (Pintrauterine balloon or intrauterine device is more effective than the use of hyaluronic acid gel in the prevention of intra-uterine adhesion reformation. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Viet H. Le, Paul A. Perry, Allyson L. Hale, Robert L. Gates, John C. Chandler ...

  20. Alteration of placental haemostatic mechanisms in idiopathic intrauterine growth restriction

    OpenAIRE

    García-Robles, Reggie; Deparatamento de Microbiología, Facultad de Ciencias. Pontificia Universidad Javeriana; Ayala-Ramírez, Paola Andrea; Instituto de Genética Humana, Pontificia Universidad Javeriana. Bogotá, D.C.,; Espinosa, Alejandra; Departamento de Patología, Hospital Universitario San Ignacio-Pontificia Universidad Javeriana. Bogotá, D.C.,; Olaya, Mercedes; Departamento de Patología, Hospital Universitario San Ignacio-Pontificia Universidad Javeriana. Bogotá, D.C.; Rojas, Juan Diego; Unidad de Medicina Materno Fetal, Departamento de Obstetricia y Ginecología. Hospital Universitario San Ignacio-Pontificia Universidad Javeriana. Bogotá, D.C.,; Bermúdez, Martha; Instituto de Genética Humana, Pontificia Universidad Javeriana. Bogotá, D.C.,; Bernal, Jaime Eduardo; Instituto de Genética Humana, Pontificia Universidad Javeriana. Bogotá, D.C.,

    2012-01-01

    Intrauterine growth restriction is a complication of pregnancy with a high probability of perinatal morbidity and mortality. It appears to be caused by abnormal development of placental vasculature. Haemostatic processes are important for the development of the placenta, and an imbalance between procoagulant and anticoagulant factors has been associated with risk of intrauterine growth restriction. Objective. To evaluate coagulation abnormalities in placenta of pregnancies complicated with id...

  1. Postplacental intrauterine device expulsion by 12 weeks: a prospective cohort study.

    Science.gov (United States)

    Goldthwaite, Lisa M; Sheeder, Jeanelle; Hyer, Jennifer; Tocce, Kristina; Teal, Stephanie B

    2017-12-01

    An intrauterine device placed immediately following a delivery can serve as an effective and safe contraceptive strategy in the postpartum period. There is limited evidence that the levonorgestrel intrauterine system may have a higher rate of expulsion compared to the copper intrauterine device; however, rates of expulsion for these 2 intrauterine device types have not been compared directly. We sought to compare expulsion rates by 12 weeks' postpartum for the levonorgestrel intrauterine system and copper intrauterine device. We enrolled women who received postplacental intrauterine devices at 2 urban hospitals. Eligible women were ≥18 years old, English- or Spanish-speaking, with singleton vaginal delivery at ≥35 weeks' gestation. Intrauterine devices were inserted within 10 minutes of placental delivery by trained providers using ring forceps or the operator's hand. Intrauterine device location was evaluated via abdominal ultrasound at 24-48 hours' postpartum, and via transvaginal ultrasound 6 and 12 weeks later, categorizing position of the intrauterine device at the fundus, below the fundus but above the internal os, any part of the intrauterine device below the internal os (partial expulsion), or no intrauterine device visualized. Outcomes included intrauterine device expulsion and method continuation. We used multivariable logistic regression to identify factors associated with expulsion. We enrolled 123 women ages 18-40 years. Of these, 68 (55%) initiated levonorgestrel intrauterine system and 55 (45%) initiated copper intrauterine device. Groups were similar except more copper intrauterine device users were Hispanic (66% vs 38%) and fewer were primiparous (16% vs 31%). Among the 96 (78%) with 12-week follow-up, expulsion was higher for levonorgestrel intrauterine system users (21/55 or 38%) than for copper intrauterine device users (8/41 or 20%) (odds ratio, 2.55; 95% confidence interval, 0.99-6.55; P = .05). At 24 hours' postpartum, there was no

  2. Diagnostic Accuracy of Abdominal wall Ultrasonography and Local Wound Exploration in Predicting the Need for Laparotomy following Stab Wound

    Directory of Open Access Journals (Sweden)

    Ali Vafaei

    2017-01-01

    Full Text Available Introduction: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU and local wound exploration (LWE in this regard.Methods: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy.Results: 50 cases with the mean age of 28.44 ± 7.14 years were included (80% male. Sensitivity, specificity and area under the receiver operating characteristic (ROC curve of AWU were 70.58 (95% CI: 44.04 – 88.62, 93.33 (95% CI: 76.49 – 98.83, and 81.96 (95% CI: 69.91 – 94.01, respectively. These measures were 88.23 (62.25 – 97.93, 93.33 (76.49 – 98.83, and 90.78 (95% CI: 81.67 – 99.89 for LWE, respectively. The difference in overall accuracy of the two methods was not statistically significant (p = 0.0641.Conclusion: Based on the findings of the present study, AWU and LWE had the same specificity but different sensitivities in screening of anterior abdominal stab wound patients in need of laparotomy. The overall accuracy of LWE was slightly higher (91.48% versus 85.1%.

  3. Continuation of copper and levonorgestrel intrauterine devices: a retrospective cohort study.

    Science.gov (United States)

    Phillips, Sharon J; Hofler, Lisa G; Modest, Anna M; Harvey, Lara F B; Wu, Lily H; Hacker, Michele R

    2017-07-01

    Studies conflict on whether the duration of use of the copper intrauterine device is longer than that of the levonorgestrel intrauterine device, and whether women who continue using intrauterine devices differ from those who discontinue. We sought to assess continuation rates and performance of levonorgestrel intrauterine devices compared with copper intrauterine devices over a 5-year period. We performed a retrospective cohort study of 1164 individuals who underwent intrauterine device placement at an urban academic medical center. The analysis focused on a comparison of continuation rates between those using levonorgestrel intrauterine device and copper intrauterine device, factors associated with discontinuation, and intrauterine device performance. We assessed the differences in continuation at discrete time points, pregnancy, and expulsion rates using χ 2 tests and calculated hazard ratios using a multivariable Cox model. Of 1164 women who underwent contraceptive intrauterine device insertion, 956 had follow-up data available. At 2 years, 64.9% of levonorgestrel intrauterine device users continued their device, compared with 57.7% of copper intrauterine device users (P = .11). At 4 years, continuation rates were 45.1% for levonorgestrel intrauterine device and 32.6% for copper intrauterine device (P intrauterine device and 23.8% for copper intrauterine device (P = .33). Black race, primiparity, and age were positively associated with discontinuation; education was not. The hazard ratio for discontinuation of levonorgestrel intrauterine device compared with copper intrauterine device >4 years was 0.71 (95% confidence interval, 0.55-0.93) and >5 years was 0.82 (95% confidence interval, 0.64-1.05) after adjusting for race, age, parity, and education. Copper intrauterine device users were more likely to experience expulsion (10.2% copper intrauterine device vs 4.9% levonorgestrel intrauterine device, P intrauterine device vs 0.1% levonorgestrel intrauterine

  4. [Intra-uterine device and nulliparous women].

    Science.gov (United States)

    Trignol-Viguier, N; Blin, E; Marret, H

    2014-06-01

    Intra-uterine device (IUD) is one of the birth control methods, which is available for nulliparous women, even though misconceptions still remain in medical or popular opinion. Only 1.3 % of nulliparous have a IUD as contraception in France while it is the second methods used by all women, after pill. The best contraception is the one chosen by women; however, the choice for a nulliparous of an IUD may be really difficult, despite the increasing number of women wishing to use it. Long-acting reversible contraceptives utilization, including IUD, is probably one of the issues to decrease the unintended pregnancies. An exhaustive and clear information about IUD is necessary to allow an informed and real choice. This prescription must consider contraindications and medical conditions for safe insertion, especially to avoid infection by screening STD (Chlamydia trachomatis and Nesseria gonorrhoeae) in nulliparous womeneffected with usual precautions and short or SL IUD preferred. Even if side effects such as expulsion, pelvic pains or dysmenorrhea are more frequent by nulliparous, IUD is a first intention choice for contraception to be consider, that women could obtain easily, including in emergency contraception situation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Intrauterine Growth Restriction: Hungry for an Answer

    Science.gov (United States)

    Chu, Alison

    2016-01-01

    Intrauterine growth restriction (IUGR) has been defined in several ways, but in general describes a condition in which the fetus exhibits poor growth in utero. This complication of pregnancy poses a significant public health burden as well as increased morbidity and mortality for the offspring. In human IUGR, alteration in fetal glucose and insulin homeostasis occurs in an effort to conserve energy and survive at the expense of fetal growth in an environment of inadequate nutrient provision. Several animal models of IUGR have been utilized to study the effects of IUGR on fetal glucose handling, as well as the postnatal reprogramming of energy metabolite handling, which may be unmasked in adulthood as a maladaptive propensity for cardiometabolic disease. This developmental programming may be mediated in part by epigenetic modification of essential regulators of glucose homeostasis. Several pharmacological therapies and nonpharmacological lifestyle modifications have shown early promise in mitigating the risk for or severity of adult metabolic phenotypes but still require further study of unanticipated and/or untoward side effects. PMID:26889018

  6. Double jeopardy revisited: clinical decision making in unstable patients with, thoraco-abdominal stab wounds and, potential injuries in multiple body cavities.

    Science.gov (United States)

    Clarke, Damian L; Gall, Tamara M H; Thomson, Sandie R

    2011-05-01

    In the setting of the hypovolaemic patient with a thoraco-abdominal stab wound and potential injuries in both the chest and abdomen, deciding which cavity to explore first may be difficult.Opening the incorrect body cavity can delay control of tamponade or haemorrhage and exacerbate hypothermia and fluid shifts. This situation has been described as one of double jeopardy. All stab victims from July 2007 to July 2009 requiring a thoracotomy and laparotomy at the same operation were identified from a database. Demographics, site and nature of injuries, admission observations and investigations as well as operative sequence were recorded. Correct sequencing was defined as first opening the cavity with most lethal injury. Incorrect sequencing was defined as opening a cavity and finding either no injury or an injury of less severity than a simultaneous injury in the unopened cavity. The primary outcome was survival or death. Sixteen stab victims underwent thoracotomy and laparotomy during the same operation. All were male with an age range of 18–40 (mean/median 27). Median systolic blood pressure on presentation was 90 mm Hg. (quartile range 80–90 mm Hg). Median base excess was 6.5 (quartile range 12 to 2.2). All the deaths were the result of cardiac injuries. Incorrect sequencing occurred in four patients (25%). In this group there were four negative abdominal explorations prior to thoracotomy with two deaths. There was one death in the correct sequencing group. Incorrect sequencing in stab victims who require both thoracotomy and laparotomy at the same sitting is associated with a high mortality. This is especially true when the abdomen is incorrectly entered first whilst the life threatening pathology is in the chest. Clinical signs may be confusing, leading to incorrect sequencing of exploration. The common causes for confusion include failure to appreciate that cardiac tamponade does not present with bleeding and difficulty in assessing peritonism in an

  7. Mechanisms of action of intrauterine devices.

    Science.gov (United States)

    Ortiz, M E; Croxatto, H B; Bardin, C W

    1996-12-01

    The major effect of all intrauterine devices (IUD) is to induce a local inflammatory reaction in the endometrium whose cellular and humoral components are released into the uterine cavity. This inflammatory reaction has a variable effect on the reproductive strategy of the species studied. For example, this foreign body reaction can be localized within the uterus of rodents; and in farm animals it can have striking extrauterine effects. Thus, the action of IUDs in humans cannot be discerned from animals. In humans, copper ions released from Cu-IUDs enhance the inflammatory response and reach concentrations in the luminal fluids of the genital tract that are toxic for spermatozoa and embryos. In women using the IUD, the entire genital tract seems affected, at least in part, because of luminal transmission of the fluids that accumulates in the uterine lumen. This affects the function or viability of gametes, decreasing the rate of fertilization and lowering the chances of survival of any embryo that may be formed, even before it reaches the uterus. Studies on the recovery of eggs from women using IUDs and from women not using contraception show that embryos are formed in the tubes of IUD users at a much lower rate compared with nonusers. This is believed to be the major action of IUDs. Therefore, the common belief that the major mechanism of action of IUDs in women is through destruction of embryos in the uterus (i.e., abortion) is not supported by the available evidence. In Cu-IUD users, it is likely that few spermatozoa reach the distal segment of the fallopian tube, those that encounter an egg may be in poor condition. Thus, the few eggs that are fertilized have little chance for development and their possibility for survival in the altered tubal milieu become worse as they approach the uterine cavity.

  8. Outcome of intrauterine pregnancies with intrauterine device in place and effects of device location on prognosis.

    Science.gov (United States)

    Ozgu-Erdinc, A Seval; Tasdemir, Ufuk Goker; Uygur, Dilek; Aktulay, Ayla; Tasdemir, Nicel; Gulerman, H Cavidan

    2014-05-01

    This study aimed to compare the outcome of pregnancies with retained or removed intrauterine devices (IUDs) and the effect of IUD location on pregnancy outcome. In a retrospective cohort study, we searched 27,578 records of women who had CuT380 IUD inserted, and 144 pregnancies with IUD were analyzed. IUDs were removed from 114 patients and retained for 30 patients. The combined risk of adverse pregnancy outcomes (miscarriage, intrauterine fetal death, intrauterine growth retardation, preterm birth and preterm premature rupture of membranes) was 36.8% in the IUD-removed group and 63.3% in the IUD-retained group [p<.01; relative risk (RR)=2.0; 95% confidence interval (CI) 1.3-3.3]. Newborns of the IUD-retained women had significantly lower Apgar scores and significantly higher admission rate to the neonatal intensive care unit (p=.01; RR=10.8; 95% CI 1.04-111.6 and p<.01; RR=4.5; 95% CI 1.5-12.9, respectively). There were more miscarriages and adverse pregnancy outcome when the IUD was retained (16.9% vs. 66.7%) in patients with an IUD in low-lying position (p<.01; RR=3.9; 95% CI 1.8-8.6). Women who conceived with an IUD in place and chose to continue the pregnancy without removing the IUD need close follow-up, as there appears to be higher risk of adverse pregnancy and neonatal outcome. Furthermore, when the IUD is retained in the low-lying position, there is increased risk of miscarriage and adverse pregnancy outcome compared to removal of the IUD. Future randomized controlled studies are needed to determine the outcome of pregnancies with retained or removed IUD. In this study, we have evaluated the IUD location and its effect on pregnancy outcome in women with a retained or removed IUD. This study is the first to investigate the relationship between IUD location and pregnancy outcome in women who conceived with an IUD. We need evidence from a collaborative multicenter randomized trial to answer the question of whether the IUD should be removed in case of

  9. A Lower-Cost Option for Intrauterine Contraception.

    Science.gov (United States)

    Angelini, Kim

    2016-01-01

    In March 2015, the U.S. Food and Drug Administration approved Liletta (Actavis, Dublin, Ireland), a new intrauterine device for contraception. The Centers for Disease Control and Prevention recommend use of long-acting reversible contraception (LARC) as first-line pregnancy prevention. LARC efficacy rates are similar to those of sterilization, with the possibility for quick return of fertility upon removal of the device. Despite benefits and recommendations for this form of contraception, access and high cost remain barriers to use. Liletta is the first lower-cost option for intrauterine contraception. Available to qualified clinics and health centers at a reduced rate, this device may increase availability and decrease the overall cost to women who desire intrauterine contraception. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  10. Anticipated pain as a predictor of discomfort with intrauterine device placement.

    Science.gov (United States)

    Dina, Blair; Peipert, Leah J; Zhao, Qiuhong; Peipert, Jeffrey F

    2018-02-01

    Intrauterine devices have been gaining popularity for the past 2 decades. Current data report that >10% of women who use contraception are using an intrauterine device. With intrauterine device is one of the most effective forms of long-acting reversible contraception, yet evidence shows that fear of pain during intrauterine device placement deters women from choosing an intrauterine device as their contraceptive method. The objective of this analysis was to estimate the association between anticipated pain with intrauterine device placement and experienced pain. We also assessed other factors associated with increased discomfort during intrauterine device placement. We hypothesized that patients with higher levels of anticipated pain would report a higher level of discomfort during placement. We performed a secondary analysis of the Contraceptive CHOICE Project. There were 9256 patients enrolled in Contraceptive CHOICE Project from the St. Louis region from 2007-2011; data for 1149 subjects who came for their first placement of either the original 52-mg levonorgestrel intrauterine system or the copper intrauterine device were analyzed in this study. Patients were asked to report their anticipated pain before intrauterine device placement and experienced pain during placement on a 10-point visual analog scale. We assessed the association of anticipated pain, patient demographics, reproductive characteristics, and intrauterine device type with experienced pain with intrauterine device placement. The mean age of Contraceptive CHOICE Project participants in this subanalysis was 26 years. Of these 1149 study subjects, 44% were black, and 53% were of low socioeconomic status. The median expected pain score was 5 for both the levonorgestrel intrauterine system and the copper intrauterine device; the median experienced pain score was 5 for the levonorgestrel intrauterine system and 4 for the copper intrauterine device. After we controlled for parity, history of

  11. A stab wound to the axilla illustrating the importance of brachial plexus anatomy in an emergency context: a case report.

    Science.gov (United States)

    Casal, Diogo; Cunha, Teresa; Pais, Diogo; Iria, Inês; Angélica-Almeida, Maria; Millan, Gerardo; Videira-Castro, José; Goyri-O'Neill, João

    2017-01-04

    Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla. On observation in our emergency room an acute venous type of bleeding was present at the wound site and, as a result of refractory hypotension after initial management with fluids administered intravenously, he was immediately carried to our operating room. During the course of transportation, we observed that he presented hypoesthesia of the medial aspect of his arm and forearm, as well as of the ulnar side of his hand and of the palmar aspect of the last three digits and of the dorsal aspect of the last two digits. Moreover, he was not able to actively flex the joints of his middle, ring, and small fingers or to adduct or abduct all fingers. Exclusively relying on our anatomical knowledge of the axillary region, the site of the stabbing wound, and the physical neurologic examination, we were able to unequivocally pinpoint the place of the injury between the anterior division of the lower trunk of his brachial plexus and the proximal portion of the following nerves: ulnar, medial cutaneous of his arm and forearm, and the medial aspect of his median nerve. Surgery revealed a longitudinal laceration of the posterior aspect of his axillary vein, and confirmed a complete section of his ulnar nerve, his medial brachial and antebrachial cutaneous nerves, and an incomplete section of the ulnar aspect of his median nerve. All structures were repaired microsurgically. Three years after the surgery he showed a good functional outcome. We believe that this case report illustrates the relevance of a sound anatomical

  12. Intrauterine devices and risk of uterine perforation: current perspectives

    Science.gov (United States)

    Rowlands, Sam; Oloto, Emeka; Horwell, David H

    2016-01-01

    Uterine perforation is an uncommon complication of intrauterine device insertion, with an incidence of one in 1,000 insertions. Perforation may be complete, with the device totally in the abdominal cavity, or partial, with the device to varying degrees within the uterine wall. Some studies show a positive association between lactation and perforation, but a causal relationship has not been established. Very rarely, a device may perforate into bowel or the urinary tract. Perforated intrauterine devices can generally be removed successfully at laparoscopy. PMID:29386934

  13. Removal of an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy.

    Science.gov (United States)

    Peleg, David; Latta, Richard

    2013-06-01

    A woman with a viable intrauterine 12-week pregnancy and an intraabdominal levonorgestrel-releasing intrauterine device had the device successfully removed under local anesthesia. The pregnancy continued without complication. The decision to remove an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy remains controversial. Copyright © 2013 Mosby, Inc. All rights reserved.

  14. 21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

  15. Intrauterine growth retardation (IUGR): epidemiology and etiology.

    Science.gov (United States)

    Romo, Agustín; Carceller, Raquel; Tobajas, Javier

    2009-02-01

    Intrauterine growth retardation (IUGR) is mainly due to a pathologic slow-down in the fetal growth pace, resulting in a fetus that is unable to reach its growth potential. IUGR frequency will vary depending on the discrimination criteria adopted. It is extremely important to use local or national fetal growth graphs in order to avoid some confounding factors. IUGR incidence in newborns would be between 3% and 7% of the total population. In our experience it is 5.13% a figure similar to the one obtained by other authors but with a progressively higher incidence during the last decade. There are multiple maternal factors that can generally be grouped into constitutional and general factors given that they affect age, weight, race, maternal cardiac volume, etc, socioeconomic factors with key incidence in the mother's nutrition level, where a poor maternal nutrition level would be the key factor in this group. We have evaluated multiple factors as possible contributors to the IUGR risk: race, parents' age, mother's height (cm), mother's birth weight and before pregnancy (kg), ponderal gain and blood pressure during pregnancy, and previous SGA newborns. Socioeconomic factors like social class, parents' profession, habitual residence, salary, immigration, and diet were also evaluated. We also included variables such as total daily working time and time mothers spent standing up, daily sleeping time (hrs), stress self-perception test at work and primiparity age. Toxic factors during pregnancy: tobacco (active and passive), alcohol, drugs and coffee consumption. Fetal or utero-placental factors were considered. In our study, the most significant etiologic factors were: Active and passive tobacco consuming, mother's stress level, increase of total months worked during pregnancy, total daily working hours and time mothers spent standing up and finally, the parent's height. Our data support the main objective of reducing the incidence of SGA newborns after IUGR by fighting

  16. Head Injuries

    Science.gov (United States)

    ... numbness in the arms or legs. Loss of consciousness. Seizures. What causes a head injury? There are ... Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight ...

  17. Head Lice

    Science.gov (United States)

    ... Head lice cannot jump or fly. Only the direct contact with an infested person or their contaminated ... the complex world of health care and making…Sports and Exercise at Every AgeRead Article >>Exercise and ...

  18. The direct cost of traumatic secretion transfer in hermaphroditic land snails: individuals stabbed with a love dart decrease lifetime fecundity.

    Science.gov (United States)

    Kimura, Kazuki; Chiba, Satoshi

    2015-04-07

    Several taxa of simultaneously hermaphroditic land snails exhibit a conspicuous mating behaviour, the so-called shooting of love darts. During mating, such land snail species transfer a specific secretion by stabbing a mating partner's body with the love dart. It has been shown that sperm donors benefit from this traumatic secretion transfer, because the secretions manipulate the physiology of a sperm recipient and increase the donors' fertilization success. However, it is unclear whether reception of dart shooting is costly to the recipients. Therefore, the effect of sexual conflict and antagonistic arms races on the evolution of traumatic secretion transfer in land snails is still controversial. To examine this effect, we compared lifetime fecundity and longevity between the individuals that received and did not receive dart shooting from mating partners in Bradybaena pellucida. Our experiments showed that the dart-receiving snails suffered reduction in lifetime fecundity and longevity. These results suggest that the costly mating behaviour, dart shooting, generates conflict between sperm donors and recipients and that sexually antagonistic arms races have contributed to the diversification of the morphological and behavioural traits relevant to dart shooting. Our findings also support theories suggesting a violent escalation of sexual conflict in hermaphroditic animals. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  19. Selective non-operative management of stab wounds to the posterior abdomen is safe: the Pietermaritzburg experience.

    Science.gov (United States)

    Kong, Victor; Oosthuizen, George; Sartorius, Benn; Clarke, Damian

    2015-09-01

    The selective non-operative management (SNOM) of stab injuries of the anterior abdomen is well established, but its application to the posterior abdomen remains controversial. A retrospective review of 1013 patients was undertaken at a major trauma service in South Africa over a five-year period. Ninety per cent of patients were males, and the mean age was 25 years. The mean time from injury to presentation was 4h and 73% of all injuries were inflicted by knives. A total of 9% (93) of patients required a laparotomy [Group A] and 82% (833) were successfully observed without the need for operative intervention [Group B]. CT imaging was performed on 52 patients (5%) who had haematuria [Group C], 25 (3%) who had neurological deficits [Group D], and 10 (1%) with retained weapon injuries [Group E]. The accuracy of physical examination for identifying the presence of organ injury was 88%. All observed patients who required laparotomy declared themselves within 24h. There were no mortalities as direct result of our current management protocol. Selective management based on active clinical observation and serial physical examination is safe, and when coupled with the judicious use of advanced imaging, is a prudent and reliable approach in a resource constrained environment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Synchronised approach for intrauterine insemination in subfertile couples

    NARCIS (Netherlands)

    Cantineau, Astrid E. P.; Janssen, Mirjam J.; Cohlen, Ben J.; Allersma, Thomas

    2014-01-01

    Background In many countries intrauterine insemination (IUI) is the treatment of first choice for a subfertile couple when the infertility work up reveals an ovulatory cycle, at least one open Fallopian tube and sufficient spermatozoa. The final goal of this treatment is to achieve a pregnancy and

  1. Variation in guideline adherence in intrauterine insemination care.

    NARCIS (Netherlands)

    Haagen, E.C.; Nelen, W.L.D.M.; Grol, R.P.T.M.; Braat, D.D.M.; Hermens, R.P.M.G.; Kremer, J.A.M.

    2010-01-01

    Health-care delivery according to clinical practice guidelines is thought to be critical in achieving optimal outcomes. This study aimed to assess the extent to which practice performance in intrauterine insemination (IUI) care is consistent with guideline recommendations and to evaluate the

  2. Maternal morbidity and mortality associated with delivery after intrauterine death

    International Nuclear Information System (INIS)

    Ifnan, F.; Jameel, M.B.

    2006-01-01

    To determine the maternal morbidity and mortality associated with delivery after intrauterine fetal death (IUFD) and to find out the place of fetal destructive procedures and cesarean section. All women were included in the present study who presented before the onset of labour pains, after intrauterine fetal death at 26 weeks or onward with singleton pregnancy. Assessment of maternal demographic characteristics, gestational age at fetal demise, delivery-IUFD interval, mode of delivery; vaginal with or without fetal destructive procedures/cesarean section and maternal complications were the main outcome measures. There were 1834 live birth and 63 deliveries with intrauterine fetal death. Mode of delivery was vaginal in 87.4% and cesarean section in 12.6% of the cases. Twelve (21%) of the vaginal deliveries were complicated by lower urogenital tract injuries in certain cases, whereas 75% (6/8) of patients delivered by cesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, peritonitis and wound dehiscence. No maternal death was identified. Rate of delivery with intrauterine fetal death was 34.3/1000 live-birth deliveries. (author)

  3. Intrauterine adhesions at the University of Maiduguri Teaching ...

    African Journals Online (AJOL)

    Context; Menstrual abnormalities and infertility are leading gynaecological complaints which can be caused by intrauterine adhesion, a preventable condition. Hence, the need to know the common aetiological factors in our environment. Objective; To determine the mode of presentation, aetiological factors and outcome of ...

  4. (SEP-D Kit) for intra-uterine insemination (IUI)

    African Journals Online (AJOL)

    Implementation of an office-based semen preparation method (SEP-D Kit) for intra-uterine insemination (IUI): A controlled randomised study to compare the IUI pregnancy outcome between a routine (swim-up) and the SEP-D Kit method.

  5. Major complication after intrauterine vesico-amniotic shunting ...

    African Journals Online (AJOL)

    Major complication after intrauterine vesico-amniotic shunting. A Springer, R Fartacek, CA Reck, E Horcher, D Bettelheim. Abstract. Bilateral foetal uropathy is the leading cause of chronic renal failure in childhood. Vesico-amniotic shunting (VAS) is a simple, feasible, and widely used procedure for decompressing the foetal ...

  6. Reasons for Intrauterine Device Use, Discontinuation and Non-Use ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC1; UNC Project,. Lilongwe, Malawi2 ... Keywords: Intrauterine Device, IUD, Africa, Malawi, Sub-Saharan Africa, Qualitative Research. Résumé ... factors affecting method choice include individuals' knowledge and beliefs as.

  7. Indications for removal of intrauterine contraceptive devices in Jos ...

    African Journals Online (AJOL)

    Context: Intrauterine contraceptive devices (IUDs) are commonly used reversible methods of contraception. The CuT 380A is recommended for use for 10 years but common observation has shown that they are removed much earlier than the recommended duration of use. Methodology: A retrospective study of all clients ...

  8. Pelvic actinomycosis associated with intrauterine device use: case report

    Energy Technology Data Exchange (ETDEWEB)

    Alfuhaid, T. [Dept. of Medical Imaging, Univ. Health Centre and Mount Sinai Hospital, Toronto General Hospital, Toronto, Ontario (Canada); Reinhold, C. [Radiology, Gastroenterology and Gynecology, McGill Univ. Health Centre, Montreal General Hospital, Montreal, Quebec (Canada)

    2003-06-01

    Pelvic actinomycosis is a rare disease that may complicate longstanding intrauterine device (IUD) use. Its timely recognition is crucial to minimize morbidity and avoid the erroneous diagnosis of malignancy with subsequent, unnecessary surgery. We describe a case of pelvic actinomycosis. The role of magnetic resonance imaging (MRI) in recognizing this infectious disease process is stressed. (author)

  9. Rectal perforation with an intrauterine device: a case report.

    Science.gov (United States)

    Eichengreen, Courtney; Landwehr, Haley; Goldthwaite, Lisa; Tocce, Kristina

    2015-03-01

    A 27-year-old woman presented for routine examination 1 year after intrauterine device (IUD) placement; strings were not visualized. The device was found to be penetrating through the rectal mucosa. It was removed easily through the rectum during an examination under anesthesia. Perforated IUDs with rectal involvement require thoughtful surgical planning to optimize outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Missing Intrauterine Contraceptive Device amongst Clients in Enugu ...

    African Journals Online (AJOL)

    Background Missing intrauterine contraceptive device (IUCD) is a known complication of IUCD use. Objective To examine the methods of diagnosis and Management modalities of missing IUCD at the University of Nigeria Teaching Hospital, Enugu. Materials and Method This was a retrospective review of the records of all ...

  11. Profile Of Intrauterine Contraceptive Device Acceptors At The ...

    African Journals Online (AJOL)

    Background: Use of modern contraceptive methods has been shown to reduce unwanted pregnancy, high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available, are particularly suitable for women in developing countries as they ...

  12. Reasons for Intrauterine Device Use, Discontinuation and Non-Use ...

    African Journals Online (AJOL)

    The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Malawi. A unique cohort of women who had enrolled in a trial of postpartum IUD use one year earlier gave insights into reasons for using, discontinuing, or not using the IUD.

  13. Bladder stone formation over a partially migrated intrauterine ...

    African Journals Online (AJOL)

    The case of a 42-year-old woman with a forgotten intrauterine contraceptive device (IUCD) presenting with irritative bladder symptoms and cyclical haematuria is reported. The threads of the IUCD were seen in the vagina during speculum examination. Partial migration of the IUCD into the bladder and formation of a large ...

  14. Intrauterine retained fetal bones as a cause of secondary infertility ...

    African Journals Online (AJOL)

    It is believed that bones re-tained freely in the endometrial cavity behave as an intrauterine contraceptive device (IUCD). Be-cause of the many complications associated with mid-trimester dilatation and evacuation of the uterus, its role in modern gynaecology should be limited. It is suggested that retained fetal bones should ...

  15. Bladder stone formation over a partially migrated intrauterine ...

    African Journals Online (AJOL)

    for the past 3 years and cyclical haematuria for the past 6 months. Menstrual cycles were regular. She had undergone puerperal sterilisation 20 years ago. Vaginal speculum examination revealed threads of an intrauterine contraceptive device (IUCD). The threads snapped during attempts to remove the device. The patient ...

  16. Good reasons to reconsider the copper intrauterine device for ...

    African Journals Online (AJOL)

    Modern Copper Intrauterine Devices [Cu IUDs] are extremely safe, highly effective, long acting yet rapidly reversible contraceptives. They are also very cost effective and suitable for use by a wide range of women, including nulliparous as well as HIV infected women. Despite a large body of scientific evidence attesting to its ...

  17. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non‑specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years ...

  18. Intravesical Migration of a Failed and Forgotten Intrauterine ...

    African Journals Online (AJOL)

    Intrauterine contraceptive device (IUCD) is a commonly utilized reversible contraceptive technique especially in the developing world. Though effective, it is not immune to complications. Migration of the device is a rare but serious complication which may be symptomatic or asymptomatic. We report a case of a 45yr old ...

  19. Intrauterine nutrition: long-term consequences for vascular health

    Directory of Open Access Journals (Sweden)

    Szostak-Wegierek D

    2014-07-01

    Full Text Available Dorota Szostak-WegierekDepartment of Human Nutrition, Medical University of Warsaw, Warsaw, Poland Abstract: There is a growing body of evidence that improper intrauterine nutrition may negatively influence vascular health in later life. Maternal malnutrition may result in intrauterine growth retardation and, in turn, metabolic disorders such as insulin resistance, diabetes, hypertension, and dyslipidemia, and also enhanced risk of atherosclerosis and cardiovascular death in the offspring. Energy and/or protein restriction is the most critical determinant for fetal programming. However, it has also been proposed that intrauterine n-3 fatty acid deficiency may be linked to later higher blood pressure levels and reduced insulin sensitivity. Moreover, it has been shown that inadequate supply of micronutrients such as folate, vitamin B12, vitamin A, iron, magnesium, zinc, and calcium may contribute to impaired vascular health in the progeny. In addition, hypertensive disorders of pregnancy that are linked to impaired placental blood flow and suboptimal fetal nutrition may also contribute to intrauterine growth retardation and aggravated cardiovascular risk in the offspring. On the other hand, maternal overnutrition, which often contributes to obesity and/or diabetes, may result in macrosomia and enhanced cardiometabolic risk in the offspring. Progeny of obese and/or diabetic mothers are relatively more prone to develop obesity, insulin resistance, diabetes, and hypertension. It was demonstrated that they may have permanently enhanced appetites. Their atheromatous lesions are usually more pronounced. It seems that, particularly, a maternal high-fat/junk food diet may be detrimental for vascular health in the offspring. Fetal exposure to excessive levels of saturated fatty and/or n-6 fatty acids, sucrose, fructose and salt, as well as a maternal high glycemic index diet, may also contribute to later enhanced cardiometabolic risk. Keywords: maternal

  20. Intrauterine device quo vadis? Why intrauterine device use should be revisited particularly in nulliparous women?

    Science.gov (United States)

    Wildemeersch, Dirk; Goldstuck, Norman; Hasskamp, Thomas; Jandi, Sohela; Pett, Ansgar

    2015-01-01

    Background Long-acting reversible contraceptive (LARC) methods, including intrauterine devices (IUDs) and the contraceptive implant, are considered the best methods for preventing unintended pregnancies, rapid repeat pregnancy, and abortion in young women. An opinion paper of 2012 by the American College of Obstetricians and Gynecologists recommends Mirena and Paragard for use in nulliparous and adolescent women. However, these IUDs are not designed for young women and are not optimal as they often lead to early discontinuation. Objective This article was written with the objective to respond to the urgent need to improve intrauterine contraception as it is likely that the objectives of LARC will not be met without significant improvement of IUD design. Anatomical variations in size and shape of the uterus are not sufficiently considered, producing harm and suffering, which often lead to early removal of the IUD. Proposed problem solving The article describes why IUDs should be revisited to meet the challenge of LARC and proposes how to solve these problems. The opinion statement presented here may be considered provocative but is based on hundreds of women with IUD problems who consult or are referred to the practices of the authors of this article due to the disproportion between the IUD and their small uterine cavity. The solution is simple but requires a revision of the current design of IUDs. One-dimensional (longitudinal) IUDs are likely to be the first option. Framed devices with shortened transverse arm and IUDs which adapt to the width of the given uterus are viewed as second best. Conclusion One of the reasons of the high unintended pregnancy rate in the USA may be the paucity of suitable IUDs. Also, the legal climate in the USA seems to be a problem for developers as many lawsuits have recently been reported. Clinical studies conducted in young nulliparous and adolescent women suggest that IUDs that fit well in the uterine cavity, like a shoe, result in

  1. Intrauterine device quo vadis? Why intrauterine device use should be revisited particularly in nulliparous women?

    Directory of Open Access Journals (Sweden)

    Wildemeersch D

    2015-01-01

    Full Text Available Dirk Wildemeersch,1 Norman Goldstuck,2 Thomas Hasskamp,3 Sohela Jandi,4 Ansgar Pett4 1Gynecological Outpatient Clinic and IUD Training Center, Ghent, Belgium; 2Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Western Cape, South Africa; 3GynMünster, Münster, 4Gynecological Outpatient Clinic, Berlin, Germany Background: Long-acting reversible contraceptive (LARC methods, including intrauterine devices (IUDs and the contraceptive implant, are considered the best methods for preventing unintended pregnancies, rapid repeat pregnancy, and abortion in young women. An opinion paper of 2012 by the American College of Obstetricians and Gynecologists recommends Mirena and Paragard for use in nulliparous and adolescent women. However, these IUDs are not designed for young women and are not optimal as they often lead to early discontinuation. Objective: This article was written with the objective to respond to the urgent need to improve intrauterine contraception as it is likely that the objectives of LARC will not be met without significant improvement of IUD design. Anatomical variations in size and shape of the uterus are not sufficiently considered, producing harm and suffering, which often lead to early removal of the IUD. Proposed problem solving: The article describes why IUDs should be revisited to meet the challenge of LARC and proposes how to solve these problems. The opinion statement presented here may be considered provocative but is based on hundreds of women with IUD problems who consult or are referred to the practices of the authors of this article due to the disproportion between the IUD and their small uterine cavity. The solution is simple but requires a revision of the current design of IUDs. One-dimensional (longitudinal IUDs are likely to be the first option. Framed devices with shortened transverse arm and IUDs which adapt to the width of the given

  2. Intrauterine growth standards: a cross-sectional study in a population of Nigerian newborns

    Directory of Open Access Journals (Sweden)

    Olugbenga A. Mokuolu

    2012-09-01

    Full Text Available The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the average weights of both sexes were similar; however, beyond this time point there was a consistent increase in the average weight of the males over the female babies. Growth curves for Nigerian newborn babies were generated and showed that the mean birth weight of Nigerian preterm babies was lighter than that of babies in Colorado. The impact of these differences on the classification of newborns will require further evaluation.

  3. A survey on spinal cord injuries resulting from stabbings: a case series study of 12 years' experience.

    Science.gov (United States)

    Saeidiborojeni, Hamid Reza; Moradinazar, Mehdi; Saeidiborojeni, Sepehr; Ahmadi, Alireza

    2013-01-01

    Penetrating spinal cord injuries (SCIs) are an uncommon injury and not reported very frequently. SCIs cause sensory, motor and genitourinary system problems or a combination of sensorimotor dysfunctions. These are among the most debilitating kinds of disorders and negatively affect quality of life, not only for the patient, but also for their family members. Therefore, the present study aims to evaluate complete or incomplete SCIs and the course of the injury and the prognosis for SCIs caused by stab wounds. This case-series design study was performed on 57 patients attending the emergency department of Taleqani Trauma Center (Kermanshah, Iran) due to SCIs caused by violent encounters involving sharp objects such as a knife, dagger, whittle and Bowie-knife between 1999 and 2011. An assessment of sensory and motor functions was performed as part of the neurological examination on admission, and during the treatment, using the Frankel Classification grading system, and the results were recorded. The average age of patients was 27 years (SD= 7.9, Range=17 to 46 years). The results of the study showed a proportion of cervical, thoracic and lumbar injuries of 23 (40%), 24 (42%) and 10 (18%), respectively. There was no case of cerebrospinal fluid leakage (CSF) or infection at the wound site in the subjects. Regarding the extent of the SCI, the combined neurological assessment showed that several patients (43%) had a complete SCI with no sensory and motor functions in the sacral segments and the segments below the site of injury. In 32 patients (57%) incomplete injuries were observed; i.e. they showed only some degrees of sensory-motor functions that were below the neurological level. Both complete and incomplete SCIs are of great importance because the prognosis of SCI is directly associated with the location and extent of injury. It should be considered that partial recovery from SCIs is possible in few cases of complete injuries. Therefore, all the patients should be

  4. Head Tilt

    Science.gov (United States)

    ... bones in the neck. Children with Klippel-Feil syndrome may have a short, broad neck, low hairline, and very restricted neck movement. Torticollis ... surgery may be necessary. To treat Klippel-Feil syndrome, a specialist may recommend ... to ease head and neck pain. Your pediatrician can refer you to a ...

  5. Head lice

    OpenAIRE

    Burgess, Ian F

    2011-01-01

    Head lice can only be diagnosed by finding live lice, as eggs take 7 days to hatch, and may appear viable for weeks after death of the egg. Infestation may be more likely in school children, with risks increased in children with more siblings, longer hair, or of lower socioeconomic group.

  6. Is HEADS in our heads?

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Hertz, Pernille Grarup; Blix, Charlotte

    2016-01-01

    BACKGROUND: Outpatient clinic visits are a window of opportunity to address health risk behaviors and promote a healthier lifestyle among young people. The HEADS (Home, Education, Eating, Activities, Drugs [i.e. substance use including tobacco, alcohol, and illegal drugs], Sexuality [including...... contraception], Safety, Self-harm) interview is a feasible way of exploring health risk behaviors and resilience. OBJECTIVE: The purpose of this study was to evaluate how often HEADS topics were addressed according to young patients and staff in pediatric and adult outpatient clinics. METHODS: We conducted...

  7. [A study of the predictive value of the primary review and complementary examinations in assessing the need for surgery in patients with stab wounds in the torso].

    Science.gov (United States)

    Martínez Casas, Isidro; Sancho Insenser, Joan; Climent Agustín, Marta; Membrilla Fernández, Estela; Pons Fragero, María José; Guzmán Ahumada, Juan; Grande Posa, Luis

    2013-01-01

    Observation is the gold standard for stable patients with stab wounds. The aim of the study was to analyse the value of the primary review and complementary examinations to predict the need for surgery in stab wound patients in order to decrease observation times. A retrospective study of stab wound patients recorded in a database. Clinical and diagnostic workup parameters were analysed. The main variable was the need for surgery. A total of 198 patients were included between 2006 and 2009, with a mean injury severity score (ISS) of 7.8±7, and 0.5% mortality. More than half (52%) of the patients suffered multiple wounds. Wound distribution was 23% neck, 46% thorax and 31% abdomen. Surgery was required in 73 (37%) patients (59% immediate, 27% delayed and 14% delayed). The need for surgery was associated with a lower revised trauma score (RTS), evisceration, active bleeding, and fascial penetration. Initial and control haemoglobin levels were significantly lower in patients who required surgery. A positive computerised tomography (CT) scan was associated with surgery. There were complications in 18% of patients, and they were more frequent in those who underwent surgery. There was no difference in complication rates between immediate and delayed (P=.72). Surgery was finally required in 10% of the patients with no abnormalities in the primary review and diagnostic workup, and 6% of those developed complications. None of the parameters studied could individually assess the need for surgery. Primary and secondary reviews were the most important diagnostic tool, but CT scan should be used more often. An observation period of 24 hours is recommended in torso penetrating wounds. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  8. Eccentrically located intrauterine pregnancy misdiagnosed as interstitial ectopic pregnancy.

    Science.gov (United States)

    Ash, Adam; Ko, Patrick; Dewar, Christopher; Raio, Christopher

    2010-12-01

    This is a case report of an eccentrically located intrauterine pregnancy initially diagnosed as an interstitial ectopic pregnancy. Although interstitial ectopic pregnancy represents a well-known pitfall in first-trimester sonography, the common error is to misidentify the ectopic pregnancy as intrauterine, not the reverse. Such an error is potentially catastrophic because it may lead to the inadvertent termination of a viable pregnancy. Although the role of ultrasonography for evaluation of ectopic pregnancy is well established, its diagnostic accuracy for interstitial ectopic pregnancy remains uncertain. Because of this, sonographic findings should be considered suggestive, but not diagnostic, in this setting. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  9. [Treatment of postpartum hemorrhage with intrauterine hydrostatic condom].

    Science.gov (United States)

    Sandoval García-Travesí, F A; Hinojosa-Cruz, J C; Reyes-Hernández, M U; Sandoval-Barajas, D; Lorca-Jiménez, G; Mendoza-Reyes, E; Cruz-Durán, J G

    2016-04-01

    To report of experience of intrauterine hydrostatic condom to control obstetric hemorrhage. Descriptive, retro-prospective study. The method was use in patients who had obstetric hemorrhage and do not responded to medical management during the period from March 1st to August27, 2015 in a rural facility. 955 patients that had a vaginal delivery were identified, 40 (4.1%) of which needed the application of the method. The method was unsuccessful in 2 of 40 patients (5%), one requiring emergency obstetric hysterectomy and other exploratory laparotomy with conservative measures. 11 of 40 patients (2 7.5%) required at least 1-3 globular packs transfusion. None of the 38 patients (95%) who responded to the method presented endometritis in the postpartum follow up or complications associated with the use of hydrostatic condom. The use of intrauterine hydrostatic condom is an effective method to control postpartum obstetric hemorrhage secondary to uterine atony unresponsive to medical management.

  10. [Effectiveness research of medicated γ intrauterine device and medicated genefix intrauterine device inserted immediately after abortion].

    Science.gov (United States)

    Wang, K; Cheng, Y; Yang, H; Tang, Y H; Jiang, J; Ji, F; Li, L B; Wu, S C

    2016-03-01

    To compare the effectiveness of medicated γ intrauterine device (IUD) and medicated genefix IUD inserted immediately after abortion. A multicenter clinical trail was performed for the study from Mar. 2012 to Jan. 2013. Totally 840 women who volunteered to participate were randomly allocated to γ-group (medicated γ IUD) or genefix-group (medicated genefix IUD) immediately after abortion. While 464 abortion women who had not used IUD or steroids contraceptive methods were chosen as control group. The effectiveness of the IUD were followed up for 1 year. All women were required to record the number of vaginal bleeding days and blood volume of vaginal bleeding within 3 months after abortion. At the 12(th) month, the expulsion was the most common reason for termination. The expulsion rates of genefix-group and γ-group were 2.48/100 women years and 3.12/100 women years, respectively (P>0.05). For the expulsion reasons, IUD moving down could account for more than seventy percent. The removal rate for IUD usage of two IUD groups were almost equal (3.91/100 women years verus 4.35/100 women years), the differences were not statistically significant (P>0.05). At the 90(th) day after abortion, comparing with control group, the bleeding and (or) spotting days of genefix-group and γ-group extended by 3.9 and 2.6 days respectively, the differences had statistical significance between the three groups (P0.05). The insertion of medicated genefix IUD and medicated γ IUD immediately after abortion is safe, feasible, has slight side effects and could be effective contraception.

  11. Homolog intrauterin insemination som basisbehandling af infertile par

    DEFF Research Database (Denmark)

    Helmsøe-Zinck, Lise; Vilsbøll, Tina; Andersen, A N

    1995-01-01

    Intrauterine insemination with husband's Percoll preparated sperm was performed in 179 couples in a total of 440 treatment cycles. A total of 60 pregnancies was obtained. The pregnancy and delivery rate was 13.6% and 9.3% per insemination cycle, respectively. The cumulative probabilities......-invasive treatment gives acceptable results. We recommend an ideal maximum of three treatment cycles, and at least 1-2 million spermatozoa for each insemination....

  12. Primary abdominal pregnancy following intra-uterine insemination

    Directory of Open Access Journals (Sweden)

    Sujata Kar

    2011-01-01

    Full Text Available Primary abdominal pregnancy is an extremely rare type of extrauterine pregnancy. It has been reported from many unusual intra-abdominal sites. We report a case of primary abdominal pregnancy following intra-uterine insemination (not reported earlier to our knowledge. Implanted on the anterior surface of the uterus possibly related to an endometriotic foci. Early diagnosis enabled laparoscopic management of this case.

  13. Intrauterine nutrition: long-term consequences for vascular health.

    Science.gov (United States)

    Szostak-Wegierek, Dorota

    2014-01-01

    There is a growing body of evidence that improper intrauterine nutrition may negatively influence vascular health in later life. Maternal malnutrition may result in intrauterine growth retardation and, in turn, metabolic disorders such as insulin resistance, diabetes, hypertension, and dyslipidemia, and also enhanced risk of atherosclerosis and cardiovascular death in the offspring. Energy and/or protein restriction is the most critical determinant for fetal programming. However, it has also been proposed that intrauterine n-3 fatty acid deficiency may be linked to later higher blood pressure levels and reduced insulin sensitivity. Moreover, it has been shown that inadequate supply of micronutrients such as folate, vitamin B12, vitamin A, iron, magnesium, zinc, and calcium may contribute to impaired vascular health in the progeny. In addition, hypertensive disorders of pregnancy that are linked to impaired placental blood flow and suboptimal fetal nutrition may also contribute to intrauterine growth retardation and aggravated cardiovascular risk in the offspring. On the other hand, maternal overnutrition, which often contributes to obesity and/or diabetes, may result in macrosomia and enhanced cardiometabolic risk in the offspring. Progeny of obese and/or diabetic mothers are relatively more prone to develop obesity, insulin resistance, diabetes, and hypertension. It was demonstrated that they may have permanently enhanced appetites. Their atheromatous lesions are usually more pronounced. It seems that, particularly, a maternal high-fat/junk food diet may be detrimental for vascular health in the offspring. Fetal exposure to excessive levels of saturated fatty and/or n-6 fatty acids, sucrose, fructose and salt, as well as a maternal high glycemic index diet, may also contribute to later enhanced cardiometabolic risk.

  14. Outpatient hysteroscopy with combined local intracervical and intrauterine anesthesia.

    Science.gov (United States)

    Agdi, Mohammed; Tulandi, Togas

    2010-01-01

    To evaluate the degree of pain during and after office hysteroscopy with combined intracervical and intrauterine anesthesia compared to intracervical anesthesia only. We evaluated the amount of pain experienced during office hysteroscopy using combined local intracervical and intrauterine anesthesia, 10, 30, and 60 min after, and during endometrial biopsy prospectively in 37 infertile women (study group). We used a visual analog scale ranging from 0 to 10. Seventy-six women who received only intracervical anesthesia served as historical controls. The mean ages of patients in the control and study groups were comparable. Patients' perception of pain was significantly higher during endometrial biopsy than during or after hysteroscopy in the study patients (p < 0.01, 95% CI 0-3). The mean pain score in the control group was significantly higher than that in the study group during hysteroscopy (3.3 +/- 0.2 vs. 2.2 +/- 0.3; p < 0.05, 95% CI 0-2). However, there was no significant difference in the pain scores between the control and study groups during endometrial biopsy and 10, 30, and 60 min after the procedure. Endometrial biopsy is associated with more pain than office hysteroscopy. Additional intrauterine anesthesia with 1% lidocaine significantly reduces pain sensation during office hysteroscopy. Copyright 2009 S. Karger AG, Basel.

  15. Laparoscopic removal of migrated intrauterine device embedded in intestine.

    Science.gov (United States)

    Rahnemai-Azar, Amir A; Apfel, Tehilla; Naghshizadian, Rozhin; Cosgrove, John Morgan; Farkas, Daniel T

    2014-01-01

    The intrauterine device (IUD) is a popular family planning method worldwide. Some of the complications associated with insertion of an IUD are well described in the literature. The frequency of IUD perforation is estimated to be between 0.05 and 13 per 1000 insertions. There are many reports of migrated intrauterine devices, but far fewer reports of IUDs which have penetrated into the small intestine. Herein we report a case of perforated intrauterine device embedded in the small intestine. By using a wound protector retraction device, and fashioning the anastomosis extra-corporeally, we were able to more easily perform this laparoscopically. This left the patient with a quicker recovery, and a better cosmetic result. IUD perforation into the peritoneal cavity is a known complication, and necessitates close follow-up. Most, if not all, should be removed at the time of diagnosis. In the majority of previously reported cases, removal was done through laparotomy. Even in cases where removal was attempted laparoscopically, many were later converted to laparotomy. Surgeons should be aware of different techniques, including using a wound protector retraction device, in order to facilitate laparoscopic removal.

  16. Intrauterine device insertion in the postpartum period: a systematic review.

    Science.gov (United States)

    Sonalkar, Sarita; Kapp, Nathalie

    2015-02-01

    Given new research on postpartum placement of levonorgestrel and copper intrauterine devices (IUDs), our objective was to update a prior systematic review of the safety and expulsion rates of postpartum IUDs. We searched MEDLINE, CENTRAL, LILACS, POPLINE, Web of Science, and ClinicalTrials.gov databases for articles between the database inception until July 2013. We included studies that compared IUD insertion time intervals and routes during the postpartum period. We used standard abstract forms and the United States Preventive Services Task Force grading system to summarise and assess the quality of the evidence. We included 18 articles. New evidence suggests that a levonorgestrel releasing-intrauterine system (LNG-IUS) insertion within 48 hours of delivery is safe. Postplacental insertion and insertion between 10 minutes and 48 hours after delivery result in higher expulsion rates than insertion 4 to 6 weeks postpartum, or non-postpartum insertion. Insertion at the time of caesarean section is associated with lower expulsion rates than postplacental insertion at the time of vaginal delivery. This review supports the evidence that insertion of an intrauterine contraceptive within the first 48 hours of vaginal or caesarean delivery is safe. Expulsion rates should be further studied in larger randomised controlled trials.

  17. Adverse Intrauterine Environment and Cardiac miRNA Expression

    Directory of Open Access Journals (Sweden)

    Mitchell C. Lock

    2017-12-01

    Full Text Available Placental insufficiency, high altitude pregnancies, maternal obesity/diabetes, maternal undernutrition and stress can result in a poor setting for growth of the developing fetus. These adverse intrauterine environments result in physiological changes to the developing heart that impact how the heart will function in postnatal life. The intrauterine environment plays a key role in the complex interplay between genes and the epigenetic mechanisms that regulate their expression. In this review we describe how an adverse intrauterine environment can influence the expression of miRNAs (a sub-set of non-coding RNAs and how these changes may impact heart development. Potential consequences of altered miRNA expression in the fetal heart include; Hypoxia inducible factor (HIF activation, dysregulation of angiogenesis, mitochondrial abnormalities and altered glucose and fatty acid transport/metabolism. It is important to understand how miRNAs are altered in these adverse environments to identify key pathways that can be targeted using miRNA mimics or inhibitors to condition an improved developmental response.

  18. [Definitions: small for gestational age and intrauterine growth retardation].

    Science.gov (United States)

    Ego, A

    2013-12-01

    Screening for intrauterine growth restriction (IUGR) is a major component of antenatal care, but the debate about the choice of birthweight standards is longstanding. The objective of this first chapter is to provide guidelines about optimal definition of IUGR. Literature review about available birthweight curves to define IUGR, including the analysis of their diagnosis accuracy and their relevance to identify babies at risk of poor perinatal outcomes. Intrauterine growth curves are more suitable for "normal" growth modeling than birth weight curves, and fetal growth is influenced by individual characteristics, fetal gender being the most important among them (EL2). Infants with a low birth weight are either constitutionally small babies or babies with pathological fetal growth failure. Use of "SGA" for all Small for Gestational Age infants is now recommended, "IUGR" being appropriate only for infants with pathological growth restriction (Professional consensus). Depending on reference curves, identified SGA babies and pregnancy outcomes may be different. Customized birth weight standards are based on an intrauterine growth modeling adjusted for fetal gender, maternal height, weight and parity, and appear to be the most accurate to identify SGA births at risk (EL3). However, their benefit on perinatal morbidity and mortality has not been demonstrated by prospective studies. Benefits and drawbacks of customized birth weight curves seem in favor of their use. Their application in ante and postnatal investigations is a real opportunity to standardize clinical practice and make information provided to parents more consistent. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. DINAMIKA FOLIKEL OVARIUM DOMBA PASCATRANSPLANTASI INTRAUTERIN PADA KELINCI PSEUDOPREGNANST

    Directory of Open Access Journals (Sweden)

    Ramadhan Sumarmin

    2012-09-01

    Full Text Available ABSTRAK Tujuan penelitian ini adalah untuk mengevaluasi dinamika folikel pada ovarium domba pascatransplantasi secara intrauterin pada kelinci pseudopregnansi. Transplantasi dilakukan pada kelinci pseudopregnant hari ke 1 atau ke 7. Ovarium kembali diambil pada hari ke 5, 7, atau 9 setelah transplantasi. Untuk menentukan dinamika folikel pada ovarium domba pascatransplantasi dan menghitung jumlah folikel pada berbagai tahap perkembangan, ovarium domba pascatransplantasi dijadikan preparat histologis dengan metode parafin dan pewarnaan HE. Hasilnya masih ditemukan semua tahapan perkembangan folikel (folikel primordial, primer, preantral, dan antral pada semua kelompok perlakuan. Jumlah folikel pada 5, 7 atau 9 hari pascatransplantasi menurun nyata (p<0,05 kecuali jumlah folikel primordial pada kelompok 5 hari pascatransplantasi (634,7±56,88 tidak berbeda nyata dengan kontrol (683,7±61,55. Dapat disimpulkan bahwa dinamika folikel ovarium domba pascatransplantasi pada kelinci pseudopregnansi masih dapat ditemukan pada semua kelompok perlakuan. THE FOLLICLE DYNAMICS OF EWE OVARIAN POST-INTRAUTERINE TRANSPLANTATION TO PSEUDOPREGNANCY RABBIT ABSTRACT The objective of this study was to evaluate the follicle dynamics of ewe ovarium post-intrauterine transplantation to pseudopregnanty rabbit. The experiment was concerned with the 1st or 7th days of pseudopregnancy to receive the ewe ovarium. After 5, 7, and 9 days transplantation the ewe ovarium were recollected. In order to determine the follicle dynamics of ewe ovari post-intrauterin transplantation and to count the number of each stage, the ewe ovari was prepared using the paraffin methods and staining with HE. The results showed all stages of the follicle dynamics (Primordial, Primary, Preantral and Antral follicle stages were still found in all groups of treatment. The number of follicles decreased significantly (p<0.05 except the number of Primordial follicles of the 5 days post transplantation

  20. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special ... the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a CT ...

  1. Immediate postpartum intrauterine device and implant program outcomes: a prospective analysis.

    Science.gov (United States)

    Eggebroten, Jennifer L; Sanders, Jessica N; Turok, David K

    2017-07-01

    In-hospital placement of intrauterine devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum intrauterine device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel intrauterine device may have a higher expulsion rate than the copper intrauterine device. This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 intrauterine devices, levonorgestrel intrauterine devices, and contraceptive implants. We offered enrollment in this prospective observational trial to women presenting to the University of Utah labor and delivery unit from October 2013 through February 2016 who requested an intrauterine device or implant for postpartum contraception during prenatal care or hospitalization at the time of delivery. Following informed consent, participants completed questionnaires prior to hospital discharge and at 3 and 6 months postpartum. Data on expulsions at 6 months were validated by chart abstraction. During the study period, 639 patients requested a postpartum intrauterine device or implant and 350 patients enrolled in prospective follow-up prior to discharge from the hospital. Among enrollees, 325 (93%) received their preferred contraceptive device prior to hospital discharge: 88 (27%) copper intrauterine device users, 123 (38%) levonorgestrel intrauterine device users, and 114 (35%) implant users. Participants predominantly were Hispanic (90%), were multiparous (87%), reported a household income device recipients (89%) completed follow-up. Among levonorgestrel intrauterine device users 17% reported expulsions relative to 4% of copper intrauterine device users. The adjusted hazard ratio for expulsion was 5.8 (confidence interval, 1.3-26.4). There was no statistically significant difference in

  2. Bray Head

    OpenAIRE

    Brocas, Samuel Frederick (Irish cityscape painter, watercolorist, and draftsman, 1792-1847)

    2008-01-01

    'A number of Martello towers were built around the coast of Ireland, especially along the east, from Millmount (Drogheda), to Bray, around Dublin Bay but also around Cork Harbour on the south coast. On the east coast, concentrated mainly around Dublin Bay, the towers were in line of sight of each other, providing the ability to communicate with one another, or warn of any incoming attacks.' (en.wikipedia.org/wiki/Martello_Tower#Ireland) 'Bray Head (Irish: Ceann Bre) is a hill and headland, of...

  3. Goniometer head

    International Nuclear Information System (INIS)

    Dzhazairov-Kakhramanov, V.; Berger, V.D.; Kadyrzhanov, K.K.; Zarifov, R.A.

    1994-01-01

    The goniometer head is an electromechanical instrument that performs the independent transfer of a testing sample on three coordinate axes (X, Y, Z) within limits of ±8 mm and independent rotation relative of these directions. The instrument comprises a sample holder, bellows component and three electrometer drives. The sample holder rotates around the axes X and Y, and is installed on the central arm which rotates around axis Z. One characteristic of this instrument is its independence which allows its use in any camera for researches in the field of radiation physics. 2 figs

  4. Complications Associated with Insertion of Intrauterine Pressure Catheters: An Unusual Case of Uterine Hypertonicity and Uterine Perforation Resulting in Fetal Distress after Insertion of an Intrauterine Pressure Catheter

    Directory of Open Access Journals (Sweden)

    Kara M. Rood

    2012-01-01

    Full Text Available Insertion of intrauterine pressure catheters is a routine procedure performed in labor and delivery departments, with few associated complications. There are several reports of maternal and neonatal morbidity associated with the use of intrauterine pressure catheters and their rare adverse outcomes. We report an unusual case of uterine hypertonicity resulting in fetal distress, immediately after the placement of an intrauterine pressure catheter. An emergent Cesarean section was performed for fetal distress and revealed a 5 cm vertical rent in the posterior lower uterine segment. The uterine perforation was repaired intraoperatively. Mother and infant did well and were discharged home on postoperative day four.

  5. Postnatal Growth in a Cohort of Sardinian Intrauterine Growth-Restricted Infants

    Directory of Open Access Journals (Sweden)

    Maria Grazia Clemente

    2017-01-01

    Full Text Available Recent studies have shown that infants with intrauterine growth restriction (IUGR undergo catch-up growth during infancy. The aim of our study was to evaluate the postnatal growth in a cohort of IUGR infants born in a tertiary-level Obstetric University Hospital of Northern Sardinia. An observational retrospective study was conducted on 12 IUGR (group A and 12 control infants (group B by measuring the anthropometric parameters of weight (W, length (L and head circumference (HC from birth to the 3rd postnatal year. At birth, significant differences were found between group A and group B with regard to all the auxological parameters (W, mean 1846.6 versus 3170.8 g, p < 0.0001; HC, 30.1 versus 34.4 cm, p < 0.0001; L, mean 43.4 versus 49.4 cm, p < 0.0001. During the 1st year, 8 of 12 (70% IUGR infants exhibited a significant catch-up growth in the 3 anthropometric parameters and a regular growth until the 3rd year of follow-up. The majority but not all infants born with IUGR in our series showed significant postnatal catch-up growth essentially during the first 12 months of life. An improved knowledge of the causes of IUGR will help to develop measures for its prevention and individualized treatment.

  6. The effect of intrauterine devices on acquisition and clearance of human papillomavirus.

    Science.gov (United States)

    Averbach, Sarah H; Ma, Yifei; Smith-McCune, Karen; Shiboski, Stephen; Moscicki, Anna B

    2017-04-01

    Previous studies have shown a decrease in cervical cancer associated with intrauterine device use. It has been hypothesized that intrauterine device use may alter the natural history of human papillomavirus infections, preempting development of precancerous lesions of the cervix and cervical cancer, but the effect of intrauterine devices on the natural history of human papillomavirus infection and subsequent development of cervical cancer is poorly understood. The purpose of this study was to evaluate the association between intrauterine device use and cervical high-risk human papillomavirus acquisition and clearance. This is a prospective cohort study conducted from October 2000 through June 2014 among 676 sexually active young women and girls enrolled from family planning clinics in San Francisco, CA. Data were analyzed using a Cox proportional hazards model, including time-varying indicators of intrauterine device use, and adjusting for fixed and time-dependent predictor variables. A total of 85 women used an intrauterine device at some time during follow-up. Among 14,513 study visits, women reported intrauterine device use at 505 visits. After adjusting for potential behavioral confounders, there was no association between intrauterine device use and human papillomavirus acquisition (hazard ratio, 0.50; 95% confidence interval, 0.20-1.23; P = .13) or clearance of human papillomavirus infection (hazard ratio, 1.44; 95% confidence interval, 0.76-2.72; P = .26). Current intrauterine device use is not associated with acquisition or persistence of human papillomavirus infection. Intrauterine device use is safe among women and girls with human papillomavirus infections and at risk for human papillomavirus acquisition. Intrauterine device use may play a role further downstream in the natural history of cervical cancer by inhibiting the development of precancerous lesions of the cervix in human papillomavirus-infected women, or enhancing clearance of established

  7. Pregnancy and delivery with an intrauterine device in situ: outcomes in the National Inpatient Sample Database.

    Science.gov (United States)

    Fulkerson Schaeffer, Sandy; Gimovsky, Alexis C; Aly, Hany; Mohamed, Mohamed A

    2017-10-26

    Pregnancy with intrauterine device in place is rare and there are limited data that exist regarding associated perinatal outcomes. The objective of this study is to determine the association between presence of an intrauterine device during pregnancy and spontaneous abortion, induced abortion, and preterm or small for gestational age delivery outcomes. The National Inpatient Sample database was analyzed for the years 2010 and 2011. Maternal records with an intrauterine device in situ during delivery were identified using International Classification of Diseases, Ninth Revision, diagnostic codes. Primary outcome was incidence of spontaneous abortion. Secondary outcomes were incidence of induced abortion, preterm delivery, and small for gestational age. Data were analyzed using Chi-square and Fisher's exact tests to calculate odds ratios (ORs) of abortion in association with intrauterine device in situ during pregnancy. Maternal birth records were further analyzed for adverse neonatal outcomes using logistic regression models, controlling for possible confounding variables. The data included 8,597,284 maternal birth records; 0.02% with an intrauterine device in situ. Patients with an intrauterine device in situ experienced a higher frequency of the pregnancy ending in spontaneous abortion (OR: 7.15; 95% confidence interval (CI): 5.06-10.09; p intrauterine device in place. Adjusted odds ratio for preterm delivery among women with an intrauterine device in situ was 2.04 (95% CI: 1.71-2.43; p intrauterine device, and adjusted odds ratio for delivery of a small for gestational age infant among intrauterine device cohort was 0.56 (95% CI: 0.34-0.92; p = .022), after controlling for associated demographic and clinical variables. The presence of an intrauterine device in situ during pregnancy was associated with increased spontaneous and induced abortions, and increased incidence of delivery of a preterm, but not small for gestational age infant.

  8. New developments in intrauterine device use: focus on the US

    Directory of Open Access Journals (Sweden)

    Nelson AL

    2016-09-01

    Full Text Available Anita L Nelson,1 Natasha Massoudi2 1Department of Obstetrics and Gynecology, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, CA, USA; 2American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten Abstract: Many more women in the US today rely upon intrauterine devices (IUDs than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices. Keywords: copper intrauterine device, levonorgestrel intrauterine systems, noncontraceptive benefits, same-day/quick start initiation, safety, bleeding patterns, placement pain, medical eligibility

  9. Predicting painful or difficult intrauterine device insertion in nulligravid women.

    Science.gov (United States)

    Kaislasuo, Janina; Heikinheimo, Oskari; Lähteenmäki, Pekka; Suhonen, Satu

    2014-08-01

    To assess the relationship of preinsertion vaginal ultrasound assessment and menstrual and gynecologic history as predictors of difficult or painful intrauterine device insertion in nulligravid women. Nulligravid women seeking contraception were invited to participate in this nonrandomized study and given the choice between the levonorgestrel-releasing intrauterine system or a copper-releasing intrauterine device. All 165 enrolled women were interviewed and a pelvic examination, including vaginal ultrasonography, was performed before insertion. Insertion difficulties and pain intensity were recorded and assessed against uterine measurements and background characteristics. Most insertions were assessed as easy (n=144 [89.4%]) and only two (1.2%) failed. Most women had uterine measurements smaller than the studied devices. Odds for difficulties at insertion decreased with every increasing millimeter in total uterine length (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.78-0.96, P=.006) and cervical length (OR 0.85, 95% CI 0.74-0.97, P=.02) and similarly with every decreasing degree of (straighter) flexion angle (OR 0.96, 95% CI 0.94-0.99, P=.005). No absolute threshold measurements could be determined. Still, the majority of insertions in small and flexed uteri were uneventful. Severe insertion pain was common (n=94 [58.4%]). Severe dysmenorrhea was the only predictor of insertion pain (OR 8.16 95% CI 2.56-26.02, P<.001). Ultrasonographic evaluation does not give additional information compared with clinical pelvic examination and sound measure. Although smaller uterine length measurements and steeper flexion angle more often predicted difficulties, the majority of insertions were uneventful in women with small measures. Dysmenorrhea was the only predictor of pain. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01685164. II.

  10. Economic analysis comparing induction of labour and expectant management for intrauterine, growth restriction at term (DIGITAT trial)

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Boers, Kim E.; Opmeer, Brent C.; Bijlenga, Denise; Bekedam, Dick J.; Bloemenkamp, Kitty W. M.; de Boer, Karin; Bremer, Henk A.; le Cessie, Saskia; Delemarre, Friso M. C.; Duvekot, Johannes J.; Hasaart, Tom H. M.; Kwee, Anneke; van Lith, Jan M. M.; van Meir, Claudia A.; van Pampus, Maria G.; van der Post, Joris A. M.; Rijken, Monique; Roumen, Frans J. M. E.; van der Salm, Paulien C. M.; Spaandermann, Marc E. A.; Willekes, Christine; Wijnen, Ella J.; Mol, Ben W. J.; Scherjon, Sicco A.

    2013-01-01

    Objective: Pregnancies complicated by intrauterine growth restriction (IUGR) are at increased risk for neonatal morbidity and mortality. The Dutch nationwide disproportionate intrauterine growth intervention trial at term (DIGITAT trial) showed that induction of labour and expectant monitoring were

  11. Which intrauterine growth restricted fetuses at term benefit from early labour induction? A secondary analysis of the DIGITAT randomised trial

    NARCIS (Netherlands)

    Tajik, Parvin; van Wyk, Linda; Boers, Kim E.; le Cessie, Saskia; Zafarmand, Mohammad Hadi; Roumen, Frans; van der Post, Joris A. M.; Porath, Martina; van Pampus, Maria G.; Spaanderdam, Marc E. A.; Kwee, Anneke; Duvekot, Johannes J.; Bremer, Henk A.; Delemarre, Friso M. C.; Bloemenkamp, Kitty W. M.; de Groot, Christianne J. M.; Willekes, Christine; van Lith, Jan M. M.; Bossuyt, Patrick M.; Mol, Ben W. J.; Scherjon, Sicco A.

    2014-01-01

    The Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT trial) showed that in women with suspected intrauterine growth restriction (IUGR) at term, there were no substantial outcome differences between induction of labour and expectant monitoring. The objective of the present

  12. Which intrauterine growth restricted fetuses at term benefit from early labour induction? A secondary analysis of the DIGITAT randomised trial

    NARCIS (Netherlands)

    Tajik, Parvin; van Wyk, Linda; Boers, Kim E.; le Cessie, Saskia; Zafarmand, Mohammad Hadi; Roumen, Frans; van der Post, Joris A. M.; Porath, Martina; van Pampus, Maria G.; Spaanderdami, Marc E. A.; Kwee, Anneke; Duvekot, Johannes J.; Bremer, Henk A.; Delemarre, Friso M. C.; Bloemenkamp, Kitty W. M.; de Groot, Christianne J. M.; Willekes, Christine; van Lith, Jan M. M.; Bossuyt, Patrick M.; Mol, Ben W. J.; Scherjon, Sicco A.

    Objective: The Disproportionate Intrauterine Growth Intervention Trial at Term (DIGITAT trial) showed that in women with suspected intrauterine growth restriction (IUGR) at term, there were no substantial outcome differences between induction of labour and expectant monitoring. The objective of the

  13. Intrauterine extremity gangrene and cerebral infarction at term

    DEFF Research Database (Denmark)

    Tanvig, M; Jørgensen, J S; Nybo, M

    2011-01-01

    Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG...... resonance imaging (MRI). At one year of age the boy was doing well and had prosthesis as a left arm. He had no signs of further complications. Despite thorough examination of the parents and the child, the reason for the thrombosis is still unknown....

  14. [Intrauterine device: about a rare complication and literature review].

    Science.gov (United States)

    Kallat, Adil; Ibrahimi, Ahmed; Fahsi, Otheman; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

    2017-01-01

    The intrauterine device (IUD) is the most common contraceptive method used in the world. Transuterine migration is a rare complication, accounting for 1/350 - 1/10000 insertions in the literature. We report the case of a 40-year old patient, who had had an IUD insertion 12-year before, presenting with pelvic and right lower back pain associated with intermittent hematuria and burning during urination. Radiological assessment showed calcific deposits on intra bladder IUD. The patient underwent cystostomy, without any difficulty, allowing stone and IUD extraction. A urinary catheter was left in place for 5 days and then withdrawn. The postoperative course was uneventful.

  15. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive Device

    Science.gov (United States)

    Abdulwahab-Ahmed, Abdullahi; Ogunleye, Oluwagbemiga Olabisi

    2013-01-01

    Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non-specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years earlier. Lower abdominal discomfort and a missing vaginal string may be the only pointer to this unfortunate event in the immediate post insertion period. It is pertinent to consider the possibility of an intravesical migration of a missing IUCD in a patient presenting with lower abdominal discomfort, urinary frequency, and missing IUCD string on vaginal examination. PMID:24470853

  16. Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study

    Science.gov (United States)

    El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.

    2009-01-01

    Objective: Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study examined the relation between maternal cannabis use…

  17. Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study

    NARCIS (Netherlands)

    Marroun, H. el; Tiemeier, H.; Steegers, E.A.P.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; Brink, W. van den; Huizink, A.C.

    2009-01-01

    Objective: Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study

  18. Intrauterine cannabis exposure affects fetal growth trajectories: the Generation R Study

    NARCIS (Netherlands)

    El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.

    2009-01-01

    Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study examined the

  19. Intrauterine cannabis exposure affects fetal growth trajectories: the generation R study

    NARCIS (Netherlands)

    El Marroun, H.; Tiemeier, H.; Steegers, E.A.P.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; van den Brink, W.; Huizink, A.C.

    2009-01-01

    Objective: Cannabis is the most commonly consumed illicit drug among pregnant women. Intrauterine exposure to cannabis may result in risks for the developing fetus. The importance of intrauterine growth on subsequent psychological and behavioral child development has been demonstrated. This study

  20. An Estimation of the Risk of Pseudotumor Cerebri among Users of the Levonorgestrel Intrauterine Device

    DEFF Research Database (Denmark)

    Valenzuela, Reuben M; Rai, Ruju; Kirk, Brian H

    2017-01-01

    Because of a previous association of pseudotumor cerebri (PTC) with levonorgestrel, we wished to evaluate the use of levonorgestrel-eluting intrauterine devices ("levonorgestrel intrauterine systems", LNG-IUS) in our University of Utah and Rigshospitalet PTC patients. In our retrospective series...

  1. Endoscopic Treatment of Intrauterine Device Migration into the Bladder with Stone Formation.

    Science.gov (United States)

    Sano, Masayuki; Nemoto, Kaoru; Miura, Takafumi; Suzuki, Yasutomo

    2017-01-01

    Background: An intrauterine device is commonly used for contraception globally. Although intrauterine device placement is an effective and safe method of contraception, migration into the bladder with stone formation is a rare and serious complication. The management approaches for an intrauterine device embedded in the bladder include endoscopic procedures and open surgical removal. In this study, we report the case of a patient with recurrent urinary tract infection associated with intrauterine device migration and urolithiasis, who successfully underwent endoscopic treatment combined with laser fragmentation. Case Presentation: A 22-year-old woman presented to our hospital with a 1-month history of lower abdominal pain, hematuria, and pain on urination. Transvaginal ultrasound showed a hyperechoic lesion in the bladder. A plain abdominal radiograph showed the presence of a T-shaped intrauterine device with calculus formation in the pelvis. CT revealed a vesical stone fixed to the top of the bladder wall, and there was no vesicovaginal fistula formation. She had undergone intrauterine device insertion several years previously. Cystoscopy confirmed the diagnosis. She underwent endoscopic lithotripsy, and the intrauterine device was extracted from the bladder wall. Repair of the bladder wall and disappearance of symptoms were confirmed. Conclusion: Endoscopic treatment combined with laser fragmentation of stones surrounding a migrated intrauterine device should be considered as a minimally invasive approach, which can be performed safely.

  2. [Diagnosis and management of uterine perforations after intrauterine device insertion: a report of 11 cases].

    Science.gov (United States)

    Boyon, C; Giraudet, G; Guérin Du Masgenêt, B; Lucot, J-P; Goeusse, P; Vinatier, D

    2013-05-01

    Intrauterine device insertion is common. It is however not harmless and uterine perforation can be serious. Eleven cases of uterine perforation after intrauterine device insertion were listed at Tourcoing hospital between 2005 and 2009. They were analyzed to identify risk factors of uterine perforation and specify management. The main symptom was pelvic pain (4 cases), pregnancy occurrence (3 cases) or inability to remove the IUD (2 cases). The intrauterine device was set during the first 9 months of post-partum in 7 cases, 2 patients were still breastfeeding. Seven patients underwent laparoscopy, 2 needed switch for laparotomy, one was treated by laparotomy only and one was lost of follow-up. Incidence of uterine perforation after IUD insertion ranges from 0,1 to 3/1000. Pelvic pain is the most revealing symptom. Fifteen percent of perforations complicate with adjacent organ lesion. Perforation incidence seems greater if the intrauterine device is set during the 6 first weeks of post-partum and breastfeeding, but non influenced by operator practical experience. Ultrasound follow-up of patients carrying intrauterine device is controversial. Facing a suspicion of ectopic intrauterine device, pelvic ultrasound examination is the first step imaging modality and using 3D could be useful. If it fails to localize the intrauterine device, an abdominal X-ray must be performed. Ectopic intrauterine device removal is recommended. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  3. Trend in the use of Intra-uterine Contraceptive Device (IUCD ,TCU ...

    African Journals Online (AJOL)

    OBJECTIVE: To estimate the acceptance rate and trend of Intrauterine Contraceptive Device (IUCD) use in Enugu,Nigeria PATIENTS AND METHODS: A review of all new acceptors of intrauterine contraceptive device (IUCD) over a nine year period(1999-2007) . RESULTS: A total of 133,375 clients were seen at the UNTH ...

  4. Fatal illness associated with pulmonary hypertension in a neonate caused by intrauterine echovirus 11 infection

    NARCIS (Netherlands)

    Willems, A.; Benne, CA; Timmer, A; Bergman, K.A.

    Nonpolio enterovirus (NPEV) infections are known to cause a wide range of illnesses in the neonatal period. In most cases, NPEV is presumed to be contracted during birth. Intrauterine NPEV infections occur infrequently. A case of Intrauterine echovirus 11 infection with pneumonia, persistent

  5. Folic acid sensitive birth defects in association with intrauterine exposure to folic acid antagonists

    NARCIS (Netherlands)

    Meijer, W.M.; Walle, H.E.K.de; Kerstjens-Frederikse, W.S; de Jong-van den Berg, Lolkje Theodora Wilhelmina

    2005-01-01

    Since the protective effect of folic acid (FA) on birth defects is well known, it is reasonable to assume intrauterine exposure to FA antagonists increases the risk on these defects. We have therefore performed case-control analyses to investigate the risk of intrauterine exposure to FA antagonists,

  6. Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy.

    Science.gov (United States)

    Man, J; Hutchinson, J C; Ashworth, M; Heazell, A E; Levine, S; Sebire, N J

    2016-11-01

    According to the classification system used, 15-60% of stillbirths remain unexplained, despite undergoing recommended autopsy examination, with variable attribution of fetal growth restriction (FGR) as a cause of death. Distinguishing small-for-gestational age (SGA) from pathological FGR is a challenge at postmortem examination. This study uses data from a large, well-characterized series of intrauterine death autopsies to investigate the effects of secondary changes such as fetal maceration, intrauterine retention and postmortem interval on body weight. Autopsy findings from intrauterine death investigations (2005-2013 inclusive, from Great Ormond Street Hospital and St George's Hospital, London) were collated into a research database. Growth charts published by the World Health Organization were used to determine normal expected weight centiles for fetuses born ≥ 24 weeks' gestation, and the effects of intrauterine retention (maceration) and postmortem interval were calculated. There were 1064 intrauterine deaths, including 533 stillbirths ≥ 24 weeks' gestation with a recorded birth weight. Of these, 192 (36%) had an unadjusted birth weight below the 10 th centile and were defined as SGA. The majority (86%) of stillborn SGA fetuses demonstrated some degree of maceration, indicating a significant period of intrauterine retention after death. A significantly greater proportion of macerated fetuses were present in the SGA population compared with the non-SGA population (P = 0.01). There was a significant relationship between increasing intrauterine retention interval and both more severe maceration and reduction in birth weight (P autopsy and, as postmortem interval increased, fetal weight loss increased (P = 0.0001). Based on birth weight alone, 36% of stillbirths are classified as SGA. However, fetuses lose weight in utero with increasing intrauterine retention and continue to lose weight between delivery and autopsy, resulting in erroneous overestimation of

  7. Interactions between intrauterine contraceptive device use and breast-feeding status at time of intrauterine contraceptive device insertion: analysis of TCu-380A acceptors in developing countries.

    Science.gov (United States)

    Farr, G; Rivera, R

    1992-07-01

    This paper is a reassessment of earlier findings from a preliminary analysis of data from a multicenter international trial regimen on breast-feeding and non-breast-feeding women in which events related to insertion, expulsion, and removal of the TCu-380A intrauterine contraceptive device (ParaGard 380) were investigated. Performance of the TCu-380A through 12 months after insertion was compared with life-table rate analysis, chi 2, Fisher exact test, or Student's t test. Variables were events reported during intrauterine contraceptive device insertion and events throughout the 12 months of study participation by breast-feeding status. Breast-feeding among intrauterine contraceptive device users was associated with fewer insertion-related complaints and lower removal rates for bleeding and pain. No uterine perforations were reported throughout the study. Differences in the performance of the TCu-380A intrauterine contraceptive device suggest physiologic effects associated with lactational amenorrhea. The TCu-380A intrauterine contraceptive device is a viable option for women breast-feeding at the time of intrauterine contraceptive device insertion.

  8. Intrauterine Transmission of Anaplasma phagocytophilum in Persistently Infected Lambs

    Directory of Open Access Journals (Sweden)

    Snorre Stuen

    2018-02-01

    Full Text Available Anaplasma phagocytophilum, which causes the disease tick-borne fever (TBF, is the most important tick-borne pathogen in European animals. TBF may contribute to severe welfare challenges and economic losses in the Norwegian sheep industry. The bacterium causes a persistent infection in sheep and several other animal species. The objective of this study was to investigate whether intrauterine transmission occurs in persistently infected sheep. The study included thirteen 5–6-month-old unmated ewes, of which twelve were experimentally infected with A. phagocytophilum (GenBank acc. no. M73220. Four to six weeks later, all ewes were mated, and nine became pregnant. Blood samples were collected from these ewes and their offspring. If the lamb died, tissue samples were collected. The samples were analyzed with real-time PCR (qPCR targeting the msp2 gene. PCR-positive samples were further analyzed by semi-nested PCR and 16S rDNA sequencing. A total of 20 lambs were born, of which six died within two days. Six newborn lambs (30% were PCR-positive (qPCR, of which one was verified by 16S rDNA sequencing. The present study indicates that intrauterine transmission of A. phagocytophilum in persistently infected sheep may occur. The importance of these findings for the epidemiology of A. phagocytophilum needs to be further investigated.

  9. Intrauterine Telemetry to Measure Mouse Contractile Pressure In Vivo

    Science.gov (United States)

    Rada, Cara C.; Pierce, Stephanie L.; Grotegut, Chad A.; England, Sarah K.

    2015-01-01

    A complex integration of molecular and electrical signals is needed to transform a quiescent uterus into a contractile organ at the end of pregnancy. Despite the discovery of key regulators of uterine contractility, this process is still not fully understood. Transgenic mice provide an ideal model in which to study parturition. Previously, the only method to study uterine contractility in the mouse was ex vivo isometric tension recordings, which are suboptimal for several reasons. The uterus must be removed from its physiological environment, a limited time course of investigation is possible, and the mice must be sacrificed. The recent development of radiometric telemetry has allowed for longitudinal, real-time measurements of in vivo intrauterine pressure in mice. Here, the implantation of an intrauterine telemeter to measure pressure changes in the mouse uterus from mid-pregnancy until delivery is described. By comparing differences in pressures between wild type and transgenic mice, the physiological impact of a gene of interest can be elucidated. This technique should expedite the development of therapeutics used to treat myometrial disorders during pregnancy, including preterm labor. PMID:25867820

  10. Intrauterine Transmission of Anaplasma phagocytophilum in Persistently Infected Lambs.

    Science.gov (United States)

    Stuen, Snorre; Okstad, Wenche; Sagen, Anne Mette

    2018-02-28

    Anaplasma phagocytophilum, which causes the disease tick-borne fever (TBF), is the most important tick-borne pathogen in European animals. TBF may contribute to severe welfare challenges and economic losses in the Norwegian sheep industry. The bacterium causes a persistent infection in sheep and several other animal species. The objective of this study was to investigate whether intrauterine transmission occurs in persistently infected sheep. The study included thirteen 5-6-month-old unmated ewes, of which twelve were experimentally infected with A. phagocytophilum (GenBank acc. no. M73220). Four to six weeks later, all ewes were mated, and nine became pregnant. Blood samples were collected from these ewes and their offspring. If the lamb died, tissue samples were collected. The samples were analyzed with real-time PCR (qPCR) targeting the msp2 gene. PCR-positive samples were further analyzed by semi-nested PCR and 16S rDNA sequencing. A total of 20 lambs were born, of which six died within two days. Six newborn lambs (30%) were PCR-positive (qPCR), of which one was verified by 16S rDNA sequencing. The present study indicates that intrauterine transmission of A. phagocytophilum in persistently infected sheep may occur. The importance of these findings for the epidemiology of A. phagocytophilum needs to be further investigated.

  11. Intrauterine contraceptive device embedded in the omentum – case report

    Directory of Open Access Journals (Sweden)

    Zolnierczyk P

    2015-12-01

    Full Text Available Piotr Zolnierczyk, Krzysztof Cendrowski, Wlodzimierz Sawicki Department of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland Abstract: This report describes the case of a 29-year-old patient, female (nulliparous who had an intrauterine device (IUD inserted in 2010 and who has had no gynecological control since then (for 4 years. After this time, the asymptomatic patient had a gynecological appointment, during which a doctor did not find the strings of IUD in the speculum. Ultrasound examination did not reveal the presence of the IUD in the uterine cavity, which led to the suspicion of its presence outside the uterus. The patient was referred to a hospital, where she underwent ultrasound and X-ray examination of the pelvis that confirmed the presence of the IUD outside the uterus. Laparoscopy was performed during which the IUD was localized as being embedded in the omentum. It was removed by performing a resection of a part of the omentum with inflammatory infiltration. The patient was discharged home on the second postoperative day in a good condition. This case confirms the need for gynecological control and ultrasound examination shortly after insertion. An ultrasound or/and X-ray is mandatory in any case of absence of IUD strings previously visible in the vagina, if the patient did not observe its expulsion. Keywords: intrauterine device, myometrium, IUD threads, uterine cavity, ultrasound examination

  12. Nonpalpable intrauterine device threads: Is it a cause for worry?

    Science.gov (United States)

    Kathpalia, S K; Singh, M K; Grewal, D S

    2017-01-01

    Intrauterine contraceptive device is a popular and effective method of contraception. It can be inserted either as an interval procedure or after abortion or delivery. Threads are attached to the vertical limb so that the user can find out the location of the device. Sometimes the threads are not palpable by the user; this study was conducted to find out the reasons for inability to palpate the threads. The retrospective study was conducted over a period of eight years; 110 female patients who complained of inability to feel the threads were included in the study. In most of the cases the device was in the right place. In four cases the device could not be felt on uterine sounding; this could have been due to subendometrial placement of the device. There was no case of perforation by the device. Inability to feel the threads is a common complaint by the patients who are using intrauterine contraceptive device. In most of the cases the device was in correct position and could be localized by clinical examination. Ultrasonography can help in localization of the device; if used at the time of insertion it can confirm proper insertion and location of the device. This will reassure the client and the health care providers.

  13. Intra-uterine exposure of horses to Sarcocystis spp. antigens

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    A.M. Antonello

    2016-04-01

    Full Text Available The aim of this study was to examine the intra-uterine exposure to Sarcocystis spp. antigens, determining the number of foals with detectable concentrations of antibodies against these agents in the serum, before colostrum ingestion and collect data about exposure of horses to the parasite. Serum samples were collected from 195 thoroughbred mares and their newborns in two farms from southern Brazil. Parasite specific antibody responses to Sarcocystis antigens were detected using the indirect immunofluorescent antibody test (IFAT and immunoblot analysis. In 84.1% (159/189 of the pregnant mares and in 7.4% (14/189 of foals we detected antibodies anti-Sarcocystis spp. by IFAT. All samples seropositive from foals were also positive in their respective mares. Serum samples of seropositive foals by IFAT, showed no reactivity on the immunoblot, having as antigens S. neurona merozoites. In conclusion, the intra-uterine exposure to Sarcocystis spp. antigens in horses was demonstrated, with occurrence not only in mares, but also in their foals, before colostrum ingestion these occurrences were reduced.

  14. Head circumference (image)

    Science.gov (United States)

    Head circumference is a measurement of the circumference of the child's head at its largest area, above the eyebrows and ears and around the back of the head. During routine check-ups, the distance is measured ...

  15. Abnormal Head Position

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Abnormal Head Position En Español Read in Chinese What is an abnormal head posture? An abnormal or compensatory head posture occurs ...

  16. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... of the Head? What is CT Scanning of the Head? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT scanning of the head is typically ...

  17. Simultaneous laparoscopic cholecystectomy and removal of an intrauterine device translocated to the right subdiaphragmal region: a case report.

    Science.gov (United States)

    Krasniqi, Salih; Ahmeti, Elvis; Hoxha, Sejdullah A; Ymeri, Halit; Shaqiri, Ismet; Kastrati-Spahija, Nexhmije B; Krasniqi, Avdyl S

    2009-08-25

    Intrauterine devices are often accompanied by various complications, of which the uterine perforation constitutes the most dangerous one. We present a case of a 41-year-old woman complaining of right upper quadrant pain. She had an intrauterine device inserted 12 years earlier without regular follow-up. Abdominal plain X-ray revealed the intrauterine device trans-located into the right subdiaphragmal area. Abdominal ultrasound showed gallbladder stones without any other sonographic pathologic finding. Patient underwent simultaneous laparoscopic cholecystectomy and removal of the intrauterine device from the right subdiaphragmal area. Laparoscopy is an appropriate method for removal of intrauterine device translocated to the right subdiaphragmatic region.

  18. Head Impact Laboratory (HIL)

    Data.gov (United States)

    Federal Laboratory Consortium — The HIL uses testing devices to evaluate vehicle interior energy attenuating (EA) technologies for mitigating head injuries resulting from head impacts during mine/...

  19. Canadian Contraception Consensus (Part 3 of 4): Chapter 7--Intrauterine Contraception.

    Science.gov (United States)

    Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Mansouri, Shireen

    2016-02-01

    To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the relative cost and availability of cited contraceptive methods in Canada. Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e.g., contraception, sexuality, sexual health) and key words (e.g., contraception, family planning, hormonal contraception, emergency contraception). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from January 1994 to January 2015. Searches were updated on a regular basis in incorporated in the guideline to June 2015. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of the evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). CHAPTER 7: INTRAUTERINE CONTRACEPTION: 1. Intrauterine contraceptives are as effective as permanent contraception methods. (II-2) 2. The use of levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg by patients taking tamoxifen is not associated with recurrence of breast cancer. (I) 3. Intrauterine contraceptives have a number of noncontraceptive benefits. The levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg significantly decreases menstrual blood loss (I) and dysmenorrhea. (II-2) Both the copper intrauterine

  20. Maternal determinants of intrauterine growth restriction in Goa, India: a case-control study

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    DD Motghare

    2014-01-01

    Full Text Available Objective: To study the maternal determinants of intrauterine growth restriction. Methods: A case-control study was conducted at a tertiary care Hospital in the year 2009. Ninety eight cases of intrauterine growth restriction were compared to 98 controls, matched for newborns sex and type of delivery. Data was collected by interviewing the mother using a structured pretested schedule and perusal of antenatal records. Intrauterine growth restriction was defined as occurring if birth weight of the newborn is below 10th percentile for gestational age on the intrauterine growth curve. Data was analyzed using SPSS software version 17 package. Percentages, odds ratios with 95% CI and multiple logistic regression analysis were used wherever appropriate. Results: Maternal age, education, socioeconomic status and number of antenatal visits were found to be the significant socio-demographic factors associated with Intrauterine growth restriction while, maternal height, parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and anemia were the maternal biological factors found to be significantly associated on bivariate analysis. Multiple logistic regression analysis identified parity, previous spontaneous abortion, direct obstetric morbidity, indirect obstetric morbidity and antenatal visits as significant maternal determinants of intrauterine growth restriction. Conclusions: A focus on good antenatal care, especially on high risk pregnancies would go a long way in reducing the problem of intrauterine growth restriction in the community thereby ensuring a safe and healthy future for our youngest generation.

  1. Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

    Science.gov (United States)

    Mo, Xiaoliang; Qin, Guirong; Zhou, Zhoulin; Jiang, Xiaoli

    2017-10-03

    To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection. 1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion. The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively. Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

  2. Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life.

    Science.gov (United States)

    Villar, J; Smeriglio, V; Martorell, R; Brown, C H; Klein, R E

    1984-11-01

    Postnatal growth and development were studied in two groups of term infants with intrauterine growth retardation (IUGR) and one group of infants with normal birth weight up to 3 years of age (total sample, 205 infants). Infants with IUGR were classified as having low ponderal index (IUGR-LPI) or adequate ponderal index (IUGR-API). At birth, the two groups of infants with IUGR had similar birth weight, but length and head circumference measurements were significantly different. Overall, the IUGR-API infants remained lighter and shorter and had smaller head circumferences up to 30 months of age. The IUGR-LPI infants experienced catch-up growth in weight during the first months, because of greater fat deposition. At 24 months of age, the IUGR-API infants scored below the others on mental items. At 3 years of age the IUGR-API infants had the lowest values on seven of eight developmental measures and on the composite score; at these two time periods, the group with normal birth weight scored the highest, and the IUGR-LPI infants obtained intermediate values. It is concluded that infants with IUGR tend to follow postnatal growth and developmental patterns that are associated with their physical characteristics at birth.

  3. Intrauterine growth restriction and hypospadias: is there a connection?

    Science.gov (United States)

    2014-01-01

    Hypospadias is one of the most common congenital malformations of the genitourinary tract in males. It is an incomplete fusion of urethral folds early in fetal development and may be associated with other malformations of the genital tract. The etiology is poorly understood and may be hormonal, genetic, or environmental, but most often is idiopathic or multifactorial. Among many possible risk factors identified, of particular importance is low birth weight, which is defined in various ways in the literature. No mechanism has been identified for the association of low birth weight and hypospadias, but some authors propose placental insufficiency as a common inciting factor. Currently, there is no standardized approach for evaluating children with hypospadias in the setting of intrauterine growth restriction. We reviewed the available published literature on the association of hypospadias and growth restriction to determine whether it should be considered a separate entity within the category of disorders of sexual differentiation. PMID:25337123

  4. Use of levonorgestrel intrauterine system for medical indications in adolescents.

    Science.gov (United States)

    Bayer, Lisa L; Hillard, Paula J Adams

    2013-04-01

    The levonorgestrel intrauterine system (LNG-IUS) is an underused contraceptive method in adolescent populations. In addition to being a highly effective, reversible, long-acting contraception, the LNG-IUS has many noncontraceptive health benefits including reduced menstrual bleeding, decreased dysmenorrhea and pelvic pain related to endometriosis, and menstruation suppression in teens with physical or developmental disabilities. The LNG-IUS can also provide endometrial protection in teens with chronic anovulation, and may be used to treat endometrial hyperplasia and cancer. This review examines the evidence supporting the use of the LNG-IUS in adolescents for these noncontraceptive benefits. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Prognosis and risk factors for intrauterine growth retardation

    DEFF Research Database (Denmark)

    Sehested, Line Thousig; Pedersen, Pernille

    2014-01-01

    INTRODUCTION: Intrauterine growth retardation (IUGR) is the term describing a foetus that has not reached its genetic growth potential. There is no international consensus on the definition of IUGR. The aim of this study was to describe a cohort of weight-restricted neonates and their mothers...... factors and neonatal growth and outcome at six weeks, five months and 12 months of age were collected. RESULTS: A total of 73 neonates and their mothers were included. Caesarean delivery was given in 78% of the cases. Maternal risk factors included gestational hypertension (33%), smoking (24......%) and placental infarction (17%). Hypoglycaemic episodes developed in 31% of the neonates. At 12 months, 90% had caught up growth and 7% had a neurologically poor outcome. No infants died. CONCLUSION: Maternal smoking and gestational hypertension are important risk factors for the development of IUGR. Special...

  6. Successful intrauterine treatment of a patient with cobalamin C defect

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    Friedrich K. Trefz

    2016-03-01

    Full Text Available Cobalamin C (cblC defect is an inherited autosomal recessive disorder that affects cobalamin metabolism. Patients are treated with hydroxycobalamin to ameliorate the clinical features of early-onset disease and prevent clinical symptoms in late-onset disease. Here we describe a patient in whom prenatal maternal treatment with 30 mg/week hydroxycobalamin and 5 mg/day folic acid from week 15 of pregnancy prevented disease manifestation in a girl who is now 11 years old with normal IQ and only mild ophthalmic findings. The affected older sister received postnatal treatment only and is severely intellectually disabled with severe ophthalmic symptoms. This case highlights the potential of early, high-dose intrauterine treatment in a fetus affected by the cblC defect.

  7. Intrauterine Exposure to Methylmercury and Neurocognitive Functions: Minamata Disease.

    Science.gov (United States)

    Yorifuji, Takashi; Kato, Tsuguhiko; Kado, Yoko; Tokinobu, Akiko; Yamakawa, Michiyo; Tsuda, Toshihide; Sanada, Satoshi

    2015-01-01

    A large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s. The severe intrauterine exposure cases are well known, although the possible impact of low-to-moderate methylmercury exposure in utero are rarely investigated. We examined neurocognitive functions among 22 participants in Minamata, mainly using an intelligence quotient test (Wechsler Adults Intelligent Scale III), in 2012/2013. The participants tended to score low on the Index score of processing speed (PS) relative to full-scale IQ, and discrepancies between PS and other scores within each participant were observed. The lower score on PS was due to deficits in digit symbol-coding and symbol search and was associated with methylmercury concentration in umbilical cords. The residents who experienced low-to-moderate methylmercury exposure including prenatal one in Minamata manifested deficits in their cognitive functions, processing speed in particular.

  8. A CASE OF PELVIC ACTINOMYCOSIS ASSOCIATED WITH AN INTRAUTERINE DEVICE

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    Mateja Pirš

    2004-02-01

    Full Text Available Background. Actinomycosis is a rare slowly progressive infection caused by Gram-positive anaerobic bacteria from the genus Actinomyces. The disease is characterized by the formation of the abscesses surrounded by dense fibrosis that extend slowly across natural anatomic boundaries.Patients and methods. The case of a 49-year-old patient with pelvic actinomycosis associated with an intrauterine device is presented. The patient was successfully treated with the combination of antibiotic and surgical therapy.Conclusions. Pelvic actinomycosis is a rare disorder. The infection may occur as a consequence of an abdominal disease or an ascending infection from the genito-urinary tract. Diagnosis of the actinomycosis can be difficult, malignant disease if often suspected. The diagnosis is frequently not established until after surgery.

  9. Aspirin for the Prevention of Preeclampsia and Intrauterine Growth Restriction.

    Science.gov (United States)

    Roberge, Stephanie; Odibo, Anthony O; Bujold, Emmanuel

    2016-06-01

    Low-dose aspirin (LDA) has been used for several years for the prevention of preeclampsia (PE). LDA started in early pregnancy is associated with improvement of placental implantation. The best evidence suggest that LDA can prevent more than half of PE cases in high-risk women when started before 16 weeks of gestation. Moreover, LDA started in early pregnancy reduces the risk of other placenta-mediated complications such as intrauterine growth restriction (IUGR) and perinatal death. The efficacy of LDA has been demonstrated in women with abnormal first-trimester uterine artery Doppler or with prior history of chronic hypertension or preeclampsia. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Prognostic Value of Fetal Thymus Size in Intrauterine Growth Restriction.

    Science.gov (United States)

    Ekin, Atalay; Gezer, Cenk; Taner, Cuneyt Eftal; Solmaz, Ulas; Gezer, Naciye Sinem; Ozeren, Mehmet

    2016-03-01

    Our aim was to evaluate the size of the fetal thymus by sonography in pregnancies with intrauterine growth restriction (IUGR) and to search for a possible relationship between a small fetal thymus and adverse perinatal outcomes. The transverse diameter of the fetal thymus was prospectively measured in 150 healthy and 143 IUGR fetuses between 24 and 40 weeks' gestation. The fetuses with IUGR were further divided according to normal or abnormal Doppler assessment of the umbilical and middle cerebral arteries and ductus venosus. Measurements were compared with reference ranges from controls. To determine which perinatal outcomes were independently associated with a small fetal thymus, a multivariate logistic regression analysis was performed. Thymus size was significantly lower in IUGR fetuses compared to controls (P thymus size was significantly smaller in IUGR fetuses with abnormal Doppler flow compared to normal flow (P thymus in IUGR fetuses was independently associated with early delivery (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.05-1.49; P= .023), respiratory distress syndrome (OR, 1.36; 95% CI, 1.09-1.78; P= .005), early neonatal sepsis (OR, 1.65; 95% CI, 1.11-2.42; P= .001), and a longer stay in the neonatal intensive care unit (OR, 1.33; 95% CI, 1.08-1.71; P = .017). Intrauterine growth restriction is associated with fetal thymic involution, and a small fetal thymus is an early indicator of adverse perinatal outcomes in pregnancies complicated by IUGR. © 2016 by the American Institute of Ultrasound in Medicine.

  11. Disproportionate Intrauterine Growth Intervention Trial At Term: DIGITAT

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    Huisjes Anjoke JM

    2007-07-01

    Full Text Available Abstract Background Around 80% of intrauterine growth restricted (IUGR infants are born at term. They have an increase in perinatal mortality and morbidity including behavioral problems, minor developmental delay and spastic cerebral palsy. Management is controversial, in particular the decision whether to induce labour or await spontaneous delivery with strict fetal and maternal surveillance. We propose a randomised trial to compare effectiveness, costs and maternal quality of life for induction of labour versus expectant management in women with a suspected IUGR fetus at term. Methods/design The proposed trial is a multi-centre randomised study in pregnant women who are suspected on clinical grounds of having an IUGR child at a gestational age between 36+0 and 41+0 weeks. After informed consent women will be randomly allocated to either induction of labour or expectant management with maternal and fetal monitoring. Randomisation will be web-based. The primary outcome measure will be a composite neonatal morbidity and mortality. Secondary outcomes will be severe maternal morbidity, maternal quality of life and costs. Moreover, we aim to assess neurodevelopmental and neurobehavioral outcome at two years as assessed by a postal enquiry (Child Behavioral Check List-CBCL and Ages and Stages Questionnaire-ASQ. Analysis will be by intention to treat. Quality of life analysis and a preference study will also be performed in the same study population. Health technology assessment with an economic analysis is part of this so called Digitat trial (Disproportionate Intrauterine Growth Intervention Trial At Term. The study aims to include 325 patients per arm. Discussion This trial will provide evidence for which strategy is superior in terms of neonatal and maternal morbidity and mortality, costs and maternal quality of life aspects. This will be the first randomised trial for IUGR at term. Trial registration Dutch Trial Register and ISRCTN

  12. Role of the levonorgestrel intrauterine system in effective contraception

    Directory of Open Access Journals (Sweden)

    Attia AM

    2013-08-01

    Full Text Available Abdelhamid M Attia,1 Magdy M Ibrahim,1 Ahmed M Abou-Setta21Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt; 2George and Fay Yee Centre for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, CanadaAbstract: Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids.Keywords: levonorgestrel, intrauterine device, contraception, family planning, Mirena, Skyla

  13. Multiple sharp force injuries to the head - the crime of passion

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2015-01-01

    Full Text Available Introduction. The Institute of Forensic Medicine was founded by Professor Milovan Milovanović (1884- 1948 in 1923 as part of School of Medicine of the University of Belgrade, and also established the Institute’s forensic collection worthy of a museum. This paper illustrates the way Professor Milovanović made this collection into a teaching aid for student education. We present a case of crime of passion from the year 1931, from our Institute’s collection. Case Outline. The victim was a 30-year-old woman with multiple stab wounds of the head, neck and arms. It was noted in the case history that the deceased woman was a maid with a wealthy merchant, as well as that she had “dubious morals” for that time, with three wooers at the same time. Injuries to the forearms and the index finger prove that the victim tried to defend herself. In the autopsy record there is a drawn figure of a kitchen knife with a rounded blade tip, which explains the absence of stab wounds to the skull, and the presence of the impression skull fractures and crushed skull bones. It was concluded that the death occurred due to exsanguination, in turn due to transection of the left carotid artery, probably caused by sharp force, while the manner of death was homicide. Some of the most prominent autopsy findings were multiple mutilating overkill sharp force injuries, localized on the head, indicated sexually motivated murder. Conclusion. Combining the museum specimen, diagrams with injuries, drawn figure of the kitchen knife used, and photographs taken during the autopsy and the police investigation, Professor Milovanović was able to properly illustrate this intriguing case to students without a computer or a PowerPoint presentation. [Projekat Ministarstva nauke Republike Srbije, br. 45005

  14. Multiple Sharp Force Injuries to the Head - The Crime of Passion.

    Science.gov (United States)

    Nikolić, Slobodan; Živković, Vladimir

    2015-01-01

    The Institute of Forensic Medicine was founded by Professor Milovan Milovanovid (1884-1948) in 1923 as part of School of Medicine of the University of Belgrade, and also established the Institute's forensic collection worthy of a museum.This paper illustrates the way Professor Milovanovie made this collection into a teaching aid for student education. We present a case of crime of passion from the year 1931, from our Institute's collection. The victim was a 30-year-old woman with multiple stab wounds of the head, neck and arms. It was noted in the case history that the deceased woman was a maid with a wealthy merchant, as well as that she had "dubious morals" for that time, with three wooers at the same time. Injuries to the forearms and the index finger prove that the victim tried to defend herself. In the autopsy record there is a drawn figure of a kitchen knife with a rounded blade tip, which explains the absence of stab wounds to the skull, and the presence of the impression skull fractures and crushed skull bones. It was concluded that the death occurred due to exsanguination, in turn due to transection of the left carotid artery, probably caused by sharp force, while the manner of death was homicide. Some of the most prominent autopsy findings were multiple mutilating overkill sharp force injuries, localized on the head, indicated sexually motivated murder. Combining the museum specimen, diagrams with injuries, drawn figure of the kitchen knife used, and photographs taken during the autopsy and the police investigation, Professor Milovanovie was able to properly illustrate this intriguing case to students without a computer or a PowerPoint presentation.

  15. Oxidized, Regenerated Cellulose Adhesion Barrier Plus Intrauterine Device Prevents Recurrence After Adhesiolysis for Moderate to Severe Intrauterine Adhesions.

    Science.gov (United States)

    Cai, Huihua; Qiao, Lin; Song, KaiJing; He, Yuanli

    2017-01-01

    To compare the efficacy of an oxidized, regenerated cellulose adhesion barrier (Interceed; Ethicon, Somerville, NJ) combined with an intrauterine device (IUD) versus an IUD alone for preventing adhesion recurrence following hysteroscopic adhesiolysis for moderate to severe intrauterine adhesions (IUAs). Retrospective case series (Canadian Task Force classification III). Tertiary care teaching hospital. Patients undergoing treatment for moderate to severe IUAs. The severity of IUA was determined based on the American Fertility Society scoring system (mild, moderate, or severe). All cases of hysteroscopic adhesiolysis were reviewed. Seventy-six women with moderate to severe IUAs treated between March 2009 and August 2015 were included. After hysteroscopic adhesiolysis, 35 patients were treated with an IUD alone (group 1), and 41 patients were treated with Interceed plus an IUD (group 2). A second hysteroscopy was performed in all cases three months after the initial hysteroscopy and both groups achieved significant reduction in adhesion scores and grade, especially in group 2 (scores, p < .001; grade, p = .039). Compared with group 1, menstruation dysfunction, pregnancy rate, and live birth rate in group 2 improved with no statistical difference (menstruation improvement, p = .764; pregnancy rate, p = .310; live birth rate, p = .068). However, an adhesion-free uterine cavity was regained significantly owing to the fewer operations in group 2 compared with group 1 (median, 3 vs 4; p = .001). The interval from initial hysteroscopy to conception was significantly shorter in group 2 (median, 12 months vs 51 months; p < .001). For moderate to severe IUAs, Interceed combined with an IUD may be an alternative approach for reducing adhesion recurrence after hysteroscopic adhesiolysis. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  16. Head and neck cancer

    International Nuclear Information System (INIS)

    Vogl, S.E.

    1988-01-01

    This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

  17. Desferrioxamine treatment of iron overload secondary to RH isoimmunization and intrauterine transfusion in a newborn infant.

    Science.gov (United States)

    Yalaz, Mehmet; Bilgin, Betül Siyah; Köroğlu, Ozge Altun; Ay, Yılmaz; Arıkan, Ciğdem; Sagol, Sermet; Akısü, Mete; Kültürsay, Nilgün

    2011-11-01

    Intrauterine transfusion is the standard of care in the management of severe Rh isoimmunization. Desferrioxamine has been used for the treatment of iron overload secondary to hemolysis and intrauterine transfusions in Rh isoimmunization cases. Here, we report a preterm infant born at 34 weeks of gestational age who had formerly received intrauterine transfusions for Rhesus hemolytic disease and presented with severe hyperferritinemia and elevated liver enzymes in the first week of life. Desferrioxamine treatment was started due to a ferritin level of 28,800 ng/ml and continued for 13 weeks. Although the treatment was successful, we observed resistant leukopenia which resolved after the cessation of treatment. In conclusion, iron overload secondary to intrauterine transfusions can be treated successfully with desferrioxamine; however, neonatologists must be aware of the possible side effects of this drug which has been used in only a limited number of newborns.

  18. Intrauterine insemination or intracervical insemination with cryopreserved donor sperm in the natural cycle: a cohort study

    NARCIS (Netherlands)

    Kop, P. A. L.; van Wely, M.; Mol, B. W.; de Melker, A. A.; Janssens, P. M. W.; Arends, B.; Curfs, M. H. J. M.; Kortman, M.; Nap, A.; Rijnders, E.; Roovers, J. P. W. R.; Ruis, H.; Simons, A. H. M.; Repping, S.; van der Veen, F.; Mochtar, M. H.

    2015-01-01

    Does intrauterine insemination in the natural cycle lead to better pregnancy rates than intracervical insemination (ICI) in the natural cycle in women undergoing artificial insemination with cryopreserved donor sperm. In a large cohort of women undergoing artificial insemination with cryopreserved

  19. Intrauterine insemination or intracervical insemination with cryopreserved donor sperm in the natural cycle : A cohort study

    NARCIS (Netherlands)

    Kop, P. A L; Van Wely, M.; Mol, B. W.; De Melker, A. A.; Janssens, P. M W; Arends, B.; Curfs, M. H J M; Kortman, M.; Nap, A.; Rijnders, E.; Roovers, J. P W R; Ruis, H.; Simons, A. H M; Repping, S.; Van Der Veen, F.; Mochtar, M. H.

    2015-01-01

    studyquestion: Does intrauterine insemination in the natural cycle lead to better pregnancy rates than intracervical insemination (ICI) in the natural cycle in women undergoing artificial insemination with cryopreserved donor sperm. summaryanswer: In a large cohort of women undergoing artificial

  20. Intrauterine adhesions as a risk factor for failed first-trimester pregnancy termination.

    Science.gov (United States)

    Luk, Janelle; Allen, Rebecca H; Schantz-Dunn, Julianna; Goldberg, Alisa B

    2007-10-01

    Risk factors for failed first-trimester surgical abortion include endometrial distortion caused by leiomyomas, uterine anomalies and malposition and cervical stenosis. This report introduces intrauterine adhesions as an additional risk factor. A multiparous woman presented for pregnancy termination at 6 weeks' gestation. Three suction-curettage attempts failed to remove what appeared to be an intrauterine pregnancy. Rising beta-hCG levels and concern for an interstitial ectopic pregnancy prompted a diagnostic laparoscopy and exploratory laparotomy without the identification of an ectopic pregnancy. After methotrexate treatment failed, the patient underwent ultrasound-guided hysteroscopy and suction curettage using a cannula with a whistle-cut aperture for the successful removal of a pregnancy implanted behind intrauterine adhesions. Intrauterine adhesions are a cause of failed surgical abortion. Ultrasound-guided hysteroscopy may be required for diagnosis.

  1. A Real-Time Intrauterine Catheter Technique for Fetal Electrocardiogram Monitoring

    National Research Council Canada - National Science Library

    Horner, S

    2001-01-01

    ..., two sensors that include the invasive scalp electrode and intrauterine pressure catheter are used clink ally, Signal processing is required to obtain a FECG via the IC, Usually the maternal electrocardiogram (ECG...

  2. Intrauterine Growth Restriction Associated with Hematologic Abnormalities: Probable Manifestations of Placental Mesenchymal Dysplasia

    Directory of Open Access Journals (Sweden)

    Cristina Martinez-Payo

    2015-10-01

    Full Text Available Introduction - Placental mesenchymal dysplasia is a rare vascular disease associated with intrauterine growth restriction, fetal demise as well as Beckwith–Wiedemann syndrome. Some neonates present hematologic abnormalities possibly related to consumptive coagulopathy and hemolytic anemia in the placental circulation. Case report - We present a case of placental mesenchymal dysplasia in a fetus with intrauterine growth restriction and cerebellar hemorrhagic injury diagnosed in the 20th week of pregnancy. During 26th week, our patient had an intrauterine fetal demise in the context of gestational hypertension. We have detailed the ultrasound findings that made us suspect the presence of hematologic disorders during 20th week. Discussion - We believe that the cerebellar hematoma could be the consequence of thrombocytopenia accompanied by anemia. If hemorrhagic damage during fetal life is found, above all associates with an anomalous placental appearance and with intrauterine growth restriction, PMD should be suspected along other etiologies.

  3. The Histological of Ewe Ovarium Post-Intrauterine Transplantation to Pseudopregnancy Rabbit

    OpenAIRE

    Sumarmin, R; Boediono, A; Winarto, A; Yusuf, TL

    2008-01-01

    The objective of this study was to evaluate the histologycal of ewe ovarium post-intrauterin transplantation to pseudopregnancy rabbit. The experiment was concerned with the 1 or 7 days of pseudopregnancy to receive the ewe ovarian transplant. Post transplantation 5, 7 or 9 days of ewe ovarium were recollected. To determine histologically post-intrauterine transplantation of ewe ovarium, the histological preparat was prepared by the paraffin methods followed by HE staining. The result showed ...

  4. Growth patterns in children with intrauterine growth retardation and their correlation to neurocognitive development.

    Science.gov (United States)

    Fattal-Valevski, Aviva; Toledano-Alhadef, Hagit; Leitner, Yael; Geva, Ronny; Eshel, Rina; Harel, Shaul

    2009-07-01

    The relationship between somatic growth and neurocognitive outcome was studied in a cohort of 136 children with intrauterine growth retardation. The children were followed up from birth to 9 to 10 years of age by annual measurements of growth parameters, neurodevelopmental evaluations, and IQ. The rate of catch-up for height between 1 and 2 years of age was significantly higher than the catch-up for weight (P importance for prediction of subsequent neurodevelopmental outcome in children with intrauterine growth retardation.

  5. Uterine doughnut by intrauterine device-induced photon attenuation on three-phase bone scintigraphy: artifact

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2007-02-15

    A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

  6. Intrauterine Contraceptive Device Migration Presenting as Abdominal Wall Swelling: A Case Report

    Directory of Open Access Journals (Sweden)

    Imtiaz Wani

    2011-01-01

    Full Text Available A number of complications are reported with the use of intrauterine contraceptive devices. These may pursue asymptomatic course or present as an acute abdomen after migration into peritoneal cavity. The authors here are reporting an abdominal wall swelling caused by transuterine migration of a copper intrauterine contraceptive device in a 28-year-old female. An open approach was used, and impacted foreign body was retrieved.

  7. The hepatic transcriptome of young suckling and aging intrauterine growth restricted male rats

    OpenAIRE

    Freije, William A.; Thamotharan, Shanthie; Lee, Regina; Shin, Bo-Chul; Devaskar, Sherin U.

    2015-01-01

    Intrauterine growth restriction leads to the development of adult onset obesity/metabolic syndrome, diabetes mellitus, cardiovascular disease, hypertension, stroke, dyslipidemia, and non-alcoholic fatty liver disease/steatohepatitis. Continued postnatal growth restriction has been shown to ameliorate many of these sequelae. To further our understanding of the mechanism of how intrauterine and early postnatal growth affects adult health we have employed Affymetrix microarray-based expression p...

  8. The effect of intrauterine HCG injection on IVF outcome: a systematic review and meta-analysis.

    Science.gov (United States)

    Osman, A; Pundir, J; Elsherbini, M; Dave, S; El-Toukhy, T; Khalaf, Y

    2016-09-01

    In this systematic review and meta-analysis, the effect of intrauterine HCG infusion before embryo transfer on IVF outcomes (live birth rate, clinical pregnancy rate and spontaneous aboretion rate) was investigated. Searches were conducted on MEDLINE, EMBASE and The Cochrane Library. Randomized studies in women undergoing IVF and intracytoplasmic sperm injection comparing intrauterine HCG administration at embryo transfer compared with no intrauterine HCG were eligible for inclusion. Eight randomized controlled trials were eligible for inclusion in the meta-analysis. A total of 3087 women undergoing IVF and intracytoplasmic sperm injection cycles were enrolled (intrauterine HCG group: n = 1614; control group: n = 1473). No significant difference was found in the live birth rate (RR 1.13; 95% CI 0.84 to 1.53) and spontaneous abortion rate (RR 1.00, 95% CI 0.74 to 1.34) between women who received intrauterine HCG and those who did not receive HCG. Although this review was extensive and included randomized controlled trials, no significant heterogeneity was found, and the overall included numbers are relatively small. In conclusion the current evidence does not support the use of intrauterine HCG administration before embryo transfer. Well-designed multicentre trials are needed to provide robust evidence. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Intrauterine contraception in Saint Louis: A Survey of Obstetrician and Gynecologists’ knowledge and attitudes

    Science.gov (United States)

    Madden, Tessa; Allsworth, Jenifer E.; Hladky, Katherine J.; Secura, Gina M.; Peipert, Jeffrey F.

    2009-01-01

    Background Many obstacles to intrauterine contraception use exist, including provider and patient misinformation, high upfront cost, and clinician practice patterns. The aim of our study was to investigate knowledge and attitudes about intrauterine contraception among obstetricians and gynecologists in the area of Saint Louis. Study Design We mailed a self-administered, anonymous survey to 250 clinicians who provide obstetric and gynecologic care in Saint Louis City and County which included questions about demographics, training, family planning visits, and intrauterine contraceptive knowledge and use. Results The overall survey response rate among eligible clinicians was 73.7%. Clinicians who had recently finished training or saw higher numbers of contraceptive patients per week were more likely to insert intrauterine contraception than clinicians who completed training prior to 1989 or saw fewer contraceptive patients. Several misconceptions among clinicians were identified, including an association between intrauterine contraceptives and an elevated risk of pelvic inflammatory disease. Conclusions Physician misconceptions about the risks of intrauterine contraception continue to occur. Improved clinician education is greatly needed to facilitate the use of these highly effective, long-acting, reversible methods of contraception. PMID:20103447

  10. Intrauterine device embedded in omentum of postpartum patient with a markedly retroverted uterus: a case report.

    Science.gov (United States)

    Neumann, Dana A; Graversen, Joseph A; Pugh, Suzanne K

    2017-10-25

    The intrauterine device is a popular form of long-acting reversible contraception. Although generally safe, one of the most serious complications of intrauterine device use is uterine perforation. Risk factors for perforation include position of the uterus, force exerted during intrauterine device insertion, postpartum period, and breastfeeding. This case is important and needs to be reported because it highlights the need to assess risk factors for uterine perforation. It adds to the medical literature because it examines the relationship between position of the uterus and the location of uterine perforation. This case report is unusual in that it describes the mechanism and specific location of uterine perforation in relation to the position of the uterus. We present a case of an intrauterine device found in the omentum of a 30-year-old white postpartum woman with a significantly retroverted uterus after the intrauterine device threads were not visualized on speculum examination during a 6-week placement check. The intrauterine device was located and removed via laparoscopy without complication. This case report will be of interest to women's health practitioners because it illustrates the importance of identifying patients with risk factors for uterine perforation, examining the relationship between uterine position and location of perforation. This is especially significant because the true incidence of perforation may be higher than the numbers reported in the literature. There is no specific diagnostic code for uterine perforation and it is unlikely that retrospective studies can accurately identify all cases.

  11. The levonorgestrel-releasing intrauterine system: Safety, efficacy, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Megan N Beatty

    2009-07-01

    Full Text Available Megan N Beatty, Paul D BlumenthalDepartment of Obstetrics and Gynecology, Stanford University, Stanford, CA, USAAbstract: The levonorgestrel-releasing intrauterine system (LNG-IUS is a safe, effective and acceptable form of contraception used by over 150 million women worldwide. It also has a variety of noncontraceptive benefits including treatment for menorrhagia, endometriosis, and endometrial hyperplasia. The LNG-IUS has also been used in combination with estrogen for hormone replacement therapy and as an alternative to hysterectomy. Overall, the system is very well tolerated and patient satisfaction is quite high when proper education regarding possible side effects is provided. However, despite all of the obvious benefits of the LNG-IUS, utilization rates remain quite low in the developed countries, especially in the United States. This is thought to be largely secondary to the persistent negative impressions from the Dalkon Shield intrauterine experience in the 1970s. This history continues to negatively influence the opinions of both patients and health care providers with regards to intrauterine devices. Providers should resolve to educate themselves and their patients on the current indications and uses for this device, as it, and intrauterine contraception in general, remains a largely underutilized approach to a variety of women’s health issues.Keywords: Mirena®, levonorgestrel-releasing, intrauterine system, intrauterine contraceptive device

  12. Standard NIJ 0115.00 za testiranje otpornosti zaštitnih prsluka na ubode nožem i predmetima sa oštrim vrhom / NIJ 0115.00 standard for testing stab resistance of body armor

    Directory of Open Access Journals (Sweden)

    Đuro Jovanić

    2008-04-01

    Full Text Available Standard NIJ 0115.00 (prema Nacionalnom institutu pravde SAD, namenjen je za utvrđivanje minimuma tehničkih zahteva i metoda ispitivanja otpornosti zaštitnih prsluka, koji treba da zaštite gornji deo tela od uboda nožem i predmetima sa oštrim vrhom. Područje primene ovog standarda ograničeno je samo na pretnje ubodima, a ne na balističke pretnje, poput onih koje su obuhvaćene standardom NIJ 0101.04 za testiranje balističke otpornosti zaštitnih prsluka. / In this work made presentation of NIJ 0115.04. (National Institute of Justice standard, witch purpose is to establish minimum performance requirements and methods of testing for the stab resistance of body armor intended to protect the torso against slash and stab threats. The scope of the standard is limited to stab resistance only; the standard does not address ballistic threats, as those are covered by NIJ Standard 0101.04. Ballistic Resistance of Personal Body Armor.

  13. The levonorgestrel-releasing intrauterine device potentiates stress reactivity.

    Science.gov (United States)

    Aleknaviciute, Jurate; Tulen, Joke H M; De Rijke, Yolanda B; Bouwkamp, Christian G; van der Kroeg, Mark; Timmermans, Mirjam; Wester, Vincent L; Bergink, Veerle; Hoogendijk, Witte J G; Tiemeier, Henning; van Rossum, Elisabeth F C; Kooiman, Cornelis G; Kushner, Steven A

    2017-06-01

    The levonorgestrel-releasing intrauterine device (LNG-IUD) is currently recommended as a first-line contraceptive with an exclusively local intrauterine influence. However, recent clinical trials have identified side effects of LNG-IUD that appear to be systemically mediated, including depressed mood and emotional lability. We performed two experimental studies and a cross-sectional study. For each study, women were included from three groups: LNG-IUD (0.02mg/24h), oral ethinylestradiol/levonorgestrel (0.03mg/0.15mg; EE30/LNG) and natural cycling (NC). Study 1-Salivary cortisol was measured at baseline and at defined intervals following the Trier Social Stress Test (TSST). Heart rate was monitored continuously throughout the TSST. Study 2-Salivary cortisol and serum total cortisol were evaluated relative to low-dose (1μg) adrenocorticotropic hormone (ACTH) administration. Study 3-Hair cortisol was measured as a naturalistic index of long-term cortisol exposure. Women using LNG-IUD had an exaggerated salivary cortisol response to the TSST (24.95±13.45 nmol/L, 95% CI 17.49-32.40), compared to EE30/LNG (3.27±2.83 nmol/L, 95% CI 1.71-4.84) and NC (10.85±11.03nmol/L, 95% CI 6.30-15.40) (P<0.0001). Heart rate was significantly potentiated during the TSST in women using LNG-IUD (P=0.047). In response to ACTH challenge, women using LNG-IUD and EE30/LNG had a blunted salivary cortisol response, compared to NC (P<0.0001). Women using LNG-IUD had significantly elevated levels of hair cortisol compared to EE30/LNG or NC (P<0.0001). Our findings suggest that LNG-IUD contraception induces a centrally-mediated sensitization of both autonomic and hypothalamic-pituitary-adrenal (HPA) axis responsivity. LNG-IUD sensitization of HPA axis responsivity was observed acutely under standardized laboratory conditions, as well as chronically under naturalistic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Chromosomal aberrations as etiological factors of intrauterine growth retardation

    Directory of Open Access Journals (Sweden)

    Petrović Bojana

    2008-01-01

    Full Text Available Background/Aim. Intrauterine growth retardation (IUGR is a pathological condition of pregnancy characterised by birth weight below the 10th centile. A number of fetal, placental and maternal causes can lead to IUGR; although, in most cases no specific causes can be identified. The aim of this study was to determine the part of chromosomal abnormalities in IUGR etiology. Methods. Fetal blood karyotype taken by cordocentesis from 168 fetuses with diagnosed IUGR was analyzed. Results. Chromosomal rearrangements both numerical and structural were detected in 14 cases (12.2%. Two cases were triploid. Patau syndrome, Edwards syndrome and Down syndrome were found in two cases each. There was one case of trisomy 7 (47, XY, +7 and one case of trisomy 16 (47, XX, +16; one translocation, 46, XY, t (2; 14(q23; q32 and a deletion 46, XYdel (12 (p12 as well as two cases of sex chromosomes abnormalities, 45, X (Turner syndrome and 47, XYY. Conclusion. These findings suggest that a consistent number of symmetrical IUGR cases (about 12% can be associated with chromosomal rearrangements. Chromosomal aberrations that cause IUGR are heterogeneous, aberration of autosomes, mostly autosomal trisomies, being the most common.

  15. Intrauterine bacterial findings in postpartum cows with retained fetal membranes.

    Science.gov (United States)

    Bekana, M; Jonsson, P; Ekman, T; Kindahl, H

    1994-11-01

    Eleven Swedish postpartum cows with retained fetal membranes (RFM) were studied to determine the intrauterine bacterial flora. Bacteriological examination was performed from twice weekly uterine biopsies. A total of 161 biopsies were collected during the first 8 weeks postpartum of which 82 (50.9%) were found with bacterial growth. Seventy-one of the 82 bacteria-positive biopsies (86.6%) showed mixed infections whereas the remaining 11 (13.4%) were pure cultures. Generally, a total of 322 isolates belonging to 12 different genera of bacteria, 6 facultative and 6 obligate anaerobic pathogens were identified. Mixed infections were most frequent for Actinomyces pyogenes together with obligate anaerobic bacteria, especially Bacteroides levii/spp. and Fusobacterium necrophorum. All of the studied cows had an infection that involved the first two genera of bacteria, whereas F. necrophorum was found in 8 of the 11 animals. The present work suggests that a possible pathogenic synergism between A. pyogenes and the two main Gram-negative anaerobes might have caused early endometritis and/or persistent infection.

  16. The effectiveness of intrauterine insemination: A matched cohort study.

    Science.gov (United States)

    Scholten, Irma; van Zijl, Maud; Custers, Inge M; Brandes, Monique; Gianotten, Judith; van der Linden, Paul J Q; Hompes, Peter G A; van der Veen, Fulco; Mol, Ben W J

    2017-05-01

    To study the effectiveness of an intrauterine insemination (IUI) program compared to no treatment in subfertile couples with unexplained subfertility and a poor prognosis on natural conception. A retrospective matched cohort study in which ongoing pregnancy rates in 72 couples who voluntarily dropped out of treatment with IUI were compared to ongoing pregnancy rates in 144 couples who continued treatment with IUI. Couples with unexplained subfertility, mild male subfertility or cervical factor subfertility who started treatment with IUI between January 2000 and December 2008 were included. Couples were matched on hospital, age, duration of subfertility, primary or secondary subfertility and diagnosis. Primary outcome was cumulative ongoing pregnancy rate after three years. Time to pregnancy was censored at the moment couples were lost to follow up or when their child wish ended and, for the no-treatment group, when couples re-started treatment. After three years, there were 18 pregnancies in the stopped treatment group (25%) versus 41 pregnancies in the IUI group (28%) (RR 1.1 (0.59-2.2)(p=0.4)). The cumulative pregnancy rate after three years was 40% in both groups, showing no difference in time to ongoing pregnancy (shared frailty model p=0.86). In couples with unexplained subfertility and a poor prognosis for natural conception, treatment with IUI does not to add to expectant management. There is need for a randomized clinical trial comparing IUI with expectant management in these couples. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Volumetric MRI study of the intrauterine growth restriction fetal brain

    Energy Technology Data Exchange (ETDEWEB)

    Polat, A.; Barlow, S.; Ber, R.; Achiron, R.; Katorza, E. [Tel Aviv University, Sackler School of Medicine, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer (Israel)

    2017-05-15

    Intrauterine growth restriction (IUGR) is a pathologic fetal condition known to affect the fetal brain regionally and associated with future neurodevelopmental abnormalities. This study employed MRI to assess in utero regional brain volume changes in IUGR fetuses compared to controls. Retrospectively, using MRI images of fetuses at 30-34 weeks gestational age, a total of 8 brain regions - supratentorial brain and cavity, cerebral hemispheres, temporal lobes and cerebellum - were measured for volume in 13 fetuses with IUGR due to placental insufficiency and in 21 controls. Volumes and their ratios were assessed for difference using regression models. Reliability was assessed by intraclass correlation coefficients (ICC) between two observers. In both groups, all structures increase in absolute volume during that gestation period, and the rate of cerebellar growth is higher compared to that of supratentorial structures. All structures' absolute volumes were significantly smaller for the IUGR group. Cerebellar to supratentorial ratios were found to be significantly smaller (P < 0.05) for IUGR compared to controls. No other significant ratio differences were found. ICC showed excellent agreement. The cerebellar to supratentorial volume ratio is affected in IUGR fetuses. Additional research is needed to assess this as a radiologic marker in relation to long-term outcome. (orig.)

  18. Intrauterine and genetic factors in early childhood sensitization

    DEFF Research Database (Denmark)

    Bønnelykke, Klaus

    2010-01-01

    intrauterine sensitization measured by allergen-specific IgE in cord blood. Allergen-specific IgE, primarily against inhalant allergens, was detected in 14 % of cord blood samples. However, corresponding specific IgE was not detectable in infant blood at 6 months of age. Furthermore, specific IgE in cord blood......E is thought to be the result of fetal production and has been used as a marker of atopy through decades. It has been used both as an outcome in studies of prenatal risk factors and as a predictor of disease to decide on preventive measures in the infant. It is well known that falsely elevated IgE levels may...... predictive value of elevated cord blood IgE found in recent studies. Future studies should control for materno-fetal transfer of IgE or preferably use other markers of atopy. Variation in the gene coding for the skin barrier protein filaggrin (FLG) is the strongest known genetic risk factor for eczema. FLG...

  19. New developments in intrauterine device use: focus on the US

    Science.gov (United States)

    Nelson, Anita L; Massoudi, Natasha

    2016-01-01

    Many more women in the US today rely upon intrauterine devices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices. PMID:29386944

  20. [Intrauterine device and pelvic inflammatory disease: Myth or reality?

    Science.gov (United States)

    Straub, T; Reynaud, M; Yaron, M

    2018-04-04

    Intrauterine device (IUD) is a reliable contraceptive method that is long term reversible, and well tolerated. Numerous studies prove its efficiency and report rare complications that are attributed to it. However, its use is limited due to fear that it can cause a pelvic inflammatory disease (PID). This is based on historical data on infections related to the "Dalkon Shield", which was removed from the market in 1974. The analyzed articles were extracted from PUBMED database between 2000 and 2016. In total, 22 studies were retained. A meta-analysis was not possible due to the methodological diversity among the selected articles contributing to this narrative review of the literature. After analysis, the following factors influence the risk of PID linked to IUDs: an advanced age and sexually transmitted infections. The risk of PID linked to IUDs is lower than 1%. This is explained by new models of IUD, better screening tests, more frequent follow-up of the patients and the improvement of care PID patients. In the light of our results, the threat of pelvic inflammatory disease should not hinder the use of IUDs. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  1. Postplacental intrauterine device insertion at a teaching hospital.

    Science.gov (United States)

    Jatlaoui, Tara C; Marcus, Michele; Jamieson, Denise J; Goedken, Peggy; Cwiak, Carrie

    2014-06-01

    To determine whether postplacental intrauterine device (IUD) insertion can be safely and effectively performed within a teaching program. This was a prospective cohort of 177 subjects planning vaginal delivery enrolled antenatally who desired postplacental IUD insertion of either the copper T380A IUD or levonorgestrel IUS. Insertions were performed primarily by resident physicians following a training session. Follow-up included a 4- to 8-week visit and telephone calls at 3 and 6 months. Ninety-nine subjects underwent successful postplacental IUD insertion of 100 attempts. Seventeen expulsions (17%) were noted: 10 complete and 7 partial. The study identified no differences in outcome by training level; however, the study lacked statistical power to evaluate anything other than large differences. Postplacental IUD insertions can be safely and effectively performed within a training program. A training protocol may safely and feasibly be initiated among physicians, advanced practice clinicians or trainees with no prior experience with postplacental IUD insertion. By initiating this practice, access to highly effective contraception may increase for patients who have difficulty returning for a visit or otherwise receiving effective methods. © 2014.

  2. Menstrual Concerns and Intrauterine Contraception Among Adolescent Bariatric Surgery Patients

    Science.gov (United States)

    Miller, Rachel J.; Inge, Thomas H.

    2011-01-01

    Abstract Objective Adolescent obesity has dramatically increased in recent decades, and along with that so have other medical comorbidities, such as hypertension, diabetes, hyperlipidemia, nonalcoholic steatohepatitis, polycystic ovary syndrome (PCOS), and pseudotumor cerebri. Obesity and related comorbidites may be contraindications to hormonal contraception, making contraception counseling of morbidly obese adolescents more challenging. Obese adolescent females seeking bariatric surgery need effective contraception in the postoperative period. This study is designed to determine the acceptance rate of the levonorgestrel-releasing intrauterine device (IUD) and describe common menstrual problems in obese adolescent bariatric surgery patients. Methods This is a historic cohort study of adolescent females who underwent bariatric surgery over a 2-year period at a tertiary referral center for pediatric obesity. Data were systematically abstracted. The percent of patients with menstrual problems and the acceptance rate for the levonorgestrel-releasing IUD were determined. Results Twenty-five adolescents met inclusion criteria. The mean age was 17.4 years (standard deviation [SD] 2.6), and the mean body mass index (BMI) was 51.4 (SD 6.3) kg/m2. Eighty-four percent were white. Twenty-eight percent had menorrhagia, 32% had oligomenorrhea, 40% had dysmenorrhea, and 36% had PCOS. Ninety-two percent (23 of 25) underwent IUD placement. Conclusions There was a high prevalence of menstrual problems among this sample of severely obese adolescent females. The majority accepted the IUD, indicating it is a viable option among this population. PMID:21413894

  3. Neonatal cardiovascular system adaptation in babies with intrauterine growth retardation

    Directory of Open Access Journals (Sweden)

    I. N. Petrova

    2016-01-01

    Full Text Available Objective: to reveal the adaptive features of the cardiovascular system in newborn infants with intrauterine growth retardation (IUGR on the basis of a clinical instrumental study.Subjects and methods. A study group included 100 newborn infants with IUGR; a control group consisted of 40 babies with normal anthropometric measurements at birth. Medical history and clinical data and electrocardiographic and echocardiographic findings were analyzed.Results. All the examinees with IUGR had manifestations of cardiovascular system dysadaptation. There was a high rate of electrocardiographic changes, such as cardiac arrhythmias; low voltage; systolic overload of the right heart and left ventricle; signs of ventricular hypertrophy; and transient myocardial ischemia. The specific features of cardiac hemodynamics were decreased sizes of the left ventricle, lower parameters of its systolic function, and longer functioning of fetal communications.Conclusion. IUGR is associated with the development of cardiovascular system dysadaptation syndrome, which is due to prior perinatal hypoxia. The findings necessitate a follow-up of children by involving a cardiologist.

  4. Head and face reconstruction

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002980.htm Head and face reconstruction To use the sharing features on this page, please enable JavaScript. Head and face reconstruction is surgery to repair or ...

  5. Head CT scan

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    ... CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - ... Head CT is done in the hospital or radiology center. You lie on a narrow table that ...

  6. Head Lice: Diagnosis

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    ... CDC Cancel Submit Search The CDC Parasites - Lice - Head Lice Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Lice Head Lice General Information Frequently Asked Questions (FAQs) Treatment ...

  7. Head and Neck Cancer

    Science.gov (United States)

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in ...

  8. Computed Tomography (CT) -- Head

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    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, ... than regular radiographs (x-rays). top of page What are some common uses of the procedure? CT ...

  9. Head injury - first aid

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    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  10. Computed Tomography (CT) -- Head

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    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others American Stroke Association National Stroke Association ... Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine ...

  11. Randomized, controlled trial comparing the efficacy of intrauterine balloon and intrauterine contraceptive device in the prevention of adhesion reformation after hysteroscopic adhesiolysis.

    Science.gov (United States)

    Lin, Xiao-Na; Zhou, Feng; Wei, Min-Ling; Yang, Yang; Li, Ying; Li, T C; Zhang, Song-Ying

    2015-07-01

    To compare the efficacy of heart-shaped intrauterine balloon and intrauterine contraceptive device (IUD) in the prevention of adhesion reformation after hysteroscopic adhesiolysis. Prospective, randomized, controlled trial. University hospital. A total of 201 women with Asherman syndrome. Women were randomized to having either a heart-shaped intrauterine balloon or an IUD fitted after hysteroscopic adhesiolysis. The devices were removed after 7 days. A second-look hysteroscopy was carried out 1 to 2 months after the surgery. Incidence of adhesion reformation and reduction of adhesion score before and after surgery. Initially 201 cases were recruited; 39 cases dropped out, resulting in 82 cases in the balloon group and 80 cases in IUD group. The age, menstrual characteristics, pregnancy history, and American Fertility Society score before surgery were comparable between the two groups. The median adhesion score reduction (balloon group, 7; IUD group, 7) and the adhesion reformation rate (balloon group, 30%; IUD group, 35%) were not significantly different between the two groups. The heart-shaped intrauterine balloon and IUD are of similar efficacy in the prevention of adhesion reformation after hysteroscopic adhesiolysis for Asherman syndrome. ISRCTN 69690272. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Morphometry of boar sperm head and flagellum in semen backflow after insemination.

    Science.gov (United States)

    García-Vázquez, Francisco Alberto; Hernández-Caravaca, Iván; Yánez-Quintana, Wellington; Matás, Carmen; Soriano-Úbeda, Cristina; Izquierdo-Rico, María José

    2015-09-01

    Once deposited in the female reproductive system, sperm begin their competition and undergo a selection to reach the site of fertilization. Little is known about the special characteristics of sperm that reach the oviduct and are able to fertilize, with even less information on the role of sperm dimension and shape in transport and fertilization. Here, we examine whether sperm morphometry could be involved in their journey within the uterus. For this purpose, sperm head dimension (length, width, area, and perimeter) and shape (shape factor, ellipticity, elongation, and regularity), and flagellum length were analyzed in the backflow at different times after insemination (0-15, 16-30, and 31-60 minutes). Sperm morphometry in the backflow was also analyzed taking into account the site of semen deposition (cervical vs. intrauterine). Finally, flagellum length was measured at the uterotubal junction. Sperm analyzed in the backflow were small (head and flagellum) with different head shapes compared with sperm observed in the dose before insemination. The site of deposition influenced head morphometry and tail size both being smaller in the backflow after cervical insemination compared with intrauterine insemination. Mean tail length of sperm collected in the backflow was smaller than that in the insemination dose and at the uterotubal junction. Overall, our results suggest that sperm size may be involved in sperm transport either because of environment or through sperm selection and competence on their way to encounter the female gamete. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Computed Tomography (CT) -- Head

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    Full Text Available ... Perfusion of the Head CT Angiography (CTA) Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - Head Videos related to Computed Tomography ( ...

  14. Did Emperor Moctezuma II's head injury and subsequent death hasten the fall of the Aztec nation?

    Science.gov (United States)

    Sanchez, Gonzalo M

    2015-07-01

    This article analyzes the head injury of Emperor Moctezuma as one of those injuries that affected the course of history. The Emperor's death arguably changed the fate of an entire nation and led to the destruction of the Aztec civilization. Moctezuma died in the evening hours of June 30, 1520, in his palace in the Aztec capital, Tenochtitlan, while a prisoner of the Spanish conquistadors. The Emperor had been speaking to his people in an effort to persuade them to cease hostilities against Hernán Cortés, his Spanish soldiers, and Indian allies. Both Spanish and Indian contemporary sources document that he sustained a severe head injury when one of his own warriors hit him with a rock thrown from a sling. However, after the Conquest of Mexico some of the information collected by Spanish friars from Indian stories, songs, and pictorial representations raised the possibility that Moctezuma died of strangulation or stabbing at the hands of the Spaniards. There is even a suggestion of suicide. This issue remains unresolved and emotionally charged. The historical and clinical analysis of the events surrounding Moctezuma's death indicates that the Emperor most likely died as a consequence of head injury. The author has attempted to present a neutral analysis but agrees with Benjamin Keen that neutrality may be unattainable, no matter how remote the subject of historical inquiry is from the present.

  15. Best practices to minimize risk of infection with intrauterine device insertion.

    Science.gov (United States)

    Caddy, Sheila; Yudin, Mark H; Hakim, Julie; Money, Deborah M

    2014-03-01

    Intrauterine devices provide an extremely effective, long-term form of contraception that has the benefit of being reversible. Historically, the use of certain intrauterine devices was associated with increased risk of pelvic inflammatory disease. More recent evidence suggests that newer devices do not carry the same threat; however, certain risk factors can increase the possibility of infection. To review the risk of infection with the insertion of intrauterine devices and recommend strategies to prevent infection. The outcomes considered were the risk of pelvic inflammatory disease, the impact of screening for bacterial vaginosis and sexually transmitted infections including chlamydia and gonorrhea; and the role of prophylactic antibiotics. Published literature was retrieved through searches of PubMed, Embase, and The Cochrane Library on July 21, 2011, using appropriate controlled vocabulary (e.g., intrauterine devices, pelvic inflammatory disease) and key words (e.g., adnexitis, endometritis, IUD). An etiological filter was applied in PubMed. The search was limited to the years 2000 forward. There were no language restrictions. Grey (unpublished) literature was identified through searching the web sites of national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventative Health Care (Table). Recommendations 1. All women requesting an intrauterine device should be counselled about the small increased risk of pelvic inflammatory disease in the first 20 days after insertion. (II-2A) 2. All women requesting an intrauterine device should be screened by both history and physical examination for their risk of sexually transmitted infection. Women at increased risk should be tested prior to or at the time of insertion; however, it is not necessary to delay insertion until results are returned. (II-2B) 3. Not enough current evidence is available

  16. Head, Neck, and Oral Cancer

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    Full Text Available ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ...

  17. Magnetic Resonance Imaging (MRI) -- Head

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    Full Text Available ... Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses ... of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical ...

  18. CT Perfusion of the Head

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    ... Site Index A-Z CT Perfusion of the Head Computed tomography (CT) perfusion of the head uses ... the Head? What is CT Perfusion of the Head? Computed tomography (CT) perfusion imaging shows which areas ...

  19. Head, Neck, and Oral Cancer

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    Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  20. Defining and predicting 'intrauterine fetal renal failure' in congenital lower urinary tract obstruction.

    Science.gov (United States)

    Ruano, Rodrigo; Safdar, Adnan; Au, Jason; Koh, Chester J; Gargollo, Patricio; Shamshirsaz, Alireza A; Espinoza, Jimmy; Cass, Darrell L; Olutoye, Oluyinka O; Olutoye, Olutoyin A; Welty, Stephen; Roth, David R; Belfort, Michael A; Braun, Michael C

    2016-04-01

    The aim of this study was to identify predictors of 'intrauterine fetal renal failure' in fetuses with severe congenital lower urinary tract obstruction (LUTO). We undertook a retrospective study of 31 consecutive fetuses with a diagnosis of LUTO in a tertiary Fetal Center between April 2013 and April 2015. Predictors of 'intrauterine fetal renal failure' were evaluated in those infants with severe LUTO who had either a primary composite outcome measure of neonatal death in the first 24 h of life due to severe pulmonary hypoplasia or a need for renal replacement therapy within 7 days of life. The following variables were analyzed: fetal bladder re-expansion 48 h after vesicocentesis, fetal renal ultrasound characteristics, fetal urinary indices, and amniotic fluid volume. Of the 31 fetuses included in the study, eight met the criteria for 'intrauterine fetal renal failure'. All of the latter had composite poor postnatal outcomes based on death within 24 h of life (n = 6) or need for dialysis within 1 week of life (n = 2). The percentage of fetal bladder refilling after vesicocentesis at time of initial evaluation was the only predictor of 'intrauterine fetal renal failure' (cut-off renal failure' in fetuses with the most severe forms of LUTO. Fetal bladder refilling can be used to reliably predict 'intrauterine fetal renal failure', which is associated with severe pulmonary hypoplasia or the need for dialysis within a few days of life.

  1. [Effect of sexual abstinence on pregnancy rates after an intrauterine insemination].

    Science.gov (United States)

    Kably-Ambe, Alberto; Carballo-Mondragón, Esperanza; Durán-Monterrosas, Leonor; Soriano-Ortega, Karla Patricia; Roque-Sánchez, Armando Miguel

    2015-02-01

    There are many studies showing that more days of sexual abstinence increased sperm concentration, however, the direct influence between the days of abstinence and pregnancy rates has not been evaluated. The usual recommendation is 3-4 days prior to intrauterine insemination; this based on the interval that maximizes the number of motile sperm in the ejaculate. There are some reports with better success rate when abstinence is less than three days. To evaluate the pregnancy rate post-intrauterine insemination according to days of sexual abstinence prior to obtaining semen sample. A retrospective, observational and transversal study in patients attending the Mexican Center for Fertility (CEPAM) to intrauterine insemination. For analysis patients were grouped by age group, success rate and days of sexual abstinence. Continuous variables are reported as means and standard deviations; to determine statistical significance univariate logistic regression was performed. Categorical variables were evaluated in frequencies and percentages. The calculations were performed using JMP software program. 3,123 couples were included and increased success rate for intrauterine insemination was obtained with less than seven days of sexual abstinence. The rate of sperm retrieval is inversely proportional to the days of abstinence. A better pregnancy rate in intrauterine insemination was achieved with less than seven days of sexual abstinence and sperm retrieval rate was also recorded with fewer days of abstinence.

  2. Clinical and Demographic Characteristics of Women with Intrauterine Adhesion in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Efena R. Efetie

    2012-01-01

    Full Text Available Objective. Infertility menstrual abnormalities continue to constitute a significant bulk of gynecological consultation in Africa. Both of these problems are sometimes traced to intrauterine adhesions which are preventable in the majority of cases. Study Design. A retrospective analysis of intrauterine adhesions at the National Hospital Abuja, Nigeria, was carried out, covering the period from 1st September 1999 to 1st September 2004. A total of 72 cases were analyzed. Statical analysis was done using 2. Results. The incidence of intrauterine adhesions was 1.73% of new patients. Mean age ± SD was 29.97±4.82 years. Patients who were Para 0 to 1 constituted 81.9% of the total. Intrauterine adhesions significantly (<0.02 occurred in nulliparae. The majority (68% were educated only up to secondary level which was significant (<0.05. Menstrual abnormalities were present in 90.3%. The commonest predisposing factor identified was a history of dilatation and curettage or uterine evacuation. Conclusion. Intrauterine adhesions are associated with lower educational status and low parity. Increasing educational targets nationally, poverty alleviation, nationwide retraining in manual vacuum aspiration, and wider application of this technique are recommended.

  3. Sigmoid colocolic fistula caused by intrauterine device migration: a case report.

    Science.gov (United States)

    Weerasekera, Amila; Wijesinghe, Pravin; Nugaduwa, Nilhan

    2014-03-04

    The intrauterine device is a form of contraception with a long duration of action and few systemic side effects. Migration into the abdominal cavity may occur early or years after insertion giving rise to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Colocolic fistula formation is a rare but serious complication of intrauterine device migration, which may lead to difficulties in diagnosis and device retrieval. We report the case of a 29-year-old Sri Lankan woman who became pregnant 5 years after intrauterine device insertion. The device could not be located during pregnancy. She was asymptomatic and defaulted follow up during the antenatal period. She had an uncomplicated vaginal delivery. A subsequent laparotomy for device retrieval failed due to technical difficulties. A repeat laparotomy identified a sigmoid colocolic fistula with adhesions to the fallopian tube. The device was removed and colonic defects primarily closed following which the patient made an uneventful recovery. All translocated intrauterine devices should be removed regardless of type and location. This case illustrates that they may cause complex bowel lesions leading to serious technical difficulties during retrieval. With the increasing use of minimally invasive approaches for intrauterine device retrieval, a low threshold for open surgery in complicated cases is advocated.

  4. Evaluation of Abdominal Fetal Electrocardiography in Early Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Clarissa L. Velayo

    2017-06-01

    Full Text Available Objectives: This descriptive study was performed to evaluate the capability of a non-invasive transabdominal electrocardiographic system to extract clear fetal electrocardiographic (FECG measurements from intrauterine growth restricted (IUGR fetuses and to assess whether abdominal FECG parameters can be developed as markers for evaluating the fetal cardiac status in IUGR.Methods: Transabdominal FECG was attempted in 20 controls and 15 IUGR singleton pregnancies at 20+0−33+6 weeks gestation. Standard ECG parameters were compared between the study groups and evaluated for their correlation. Accuracy for the prediction of IUGR by cut off values of the different FECG parameters was also determined.Results: Clear P-QRST complexes were recognized in all cases. In the IUGR fetuses, the QT and QTc intervals were significantly prolonged (p = 0.017 and p = 0.002, respectively. There was no correlation between ECG parameters and Doppler or other indices to predict IUGR. The generation of cut off values for detecting IUGR showed increasing sensitivities but decreasing specificities with the prolongation of ECG parameters.Conclusion: The study of fetal electrocardiophysiology is now feasible through a non-invasive transabdominal route. This study confirms the potential of FECG as a clinical screening tool to aid diagnosis and management of fetuses after key limitations are addressed. In the case of IUGR, both QT and QTc intervals were significantly prolonged and thus validate earlier study findings where both these parameters were found to be markers of diastolic dysfunction. This research is a useful prelude to a test of accuracy and Receiver Operating Characteristics (ROC study.

  5. Intrauterine adhesions following an induced abortion: a nationwide cohort study.

    Science.gov (United States)

    Mentula, M; Männistö, J; Gissler, M; Heikinheimo, O; Niinimäki, M

    2018-03-13

    Intrauterine adhesions (IUA) are a problematic complication after abortion, but their incidence is unknown. Our objective was to assess the incidence of IUA following induced abortion and the risk factors for IUA. Retrospective cohort study. A nationwide registry study. All women undergoing induced abortion (n = 80 015) in Finland between 2000 and 2008. The data were retrieved from the Finnish Abortion Registry and the Hospital Discharge Registry. The diagnosis of IUA or complications was based on the diagnostic codes (ICD-10) and operative codes according to the NOMESCO Classification of Surgical Procedures (NCSP). IUA were defined as ICD-10 code N85.6 or operative code LCG02. A sub-analysis of IUA cases and five matched controls was performed. The incidence of and risk factors for IUA. A total of 12 (1.5 per 10 000) IUA diagnoses were identified from 79 960 eligible induced abortions. The rate of IUA was 1.5 and 2.0 cases per 10 000 abortions following medically and surgically induced abortion, respectively (P = 0.19). In a subgroup analysis of IUA cases and five matched controls, surgical treatment of the remaining products of conception following abortion significantly increased the risk of IUA [odds ratio 5.50 (95% CI 1.46-20.79; P = 0.012)]. IUA that require further treatment are rare after induced abortion. Surgical evacuation following medical or surgical abortion was a risk factor for diagnosis of IUA. These results suggest that trauma to a recently pregnant uterus is an important risk factor for IUA. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Women's experience with postpartum intrauterine contraceptive device use in India.

    Science.gov (United States)

    Kumar, Somesh; Sethi, Reena; Balasubramaniam, Sudharsanam; Charurat, Elaine; Lalchandani, Kamlesh; Semba, Richard; Sood, Bulbul

    2014-04-23

    Postpartum intrauterine contraceptive devices (PPIUCD) are increasingly included in many national postpartum family planning (PPFP) programs, but satisfaction of women who have adopted PPIUCD and complication rates need further characterization. Our specific aims were to describe women who accepted PPIUCD, their experience and satisfaction with their choice, and complication of expulsion or infection. We studied 2,733 married women, aged 15-49 years, who received PPIUCD in sixteen health facilities, located in eight states and the national capital territory of India, at the time of IUCD insertion and six weeks later. The satisfaction of women who received IUCD during the postpartum period and problems and complications following insertion were assessed using standardized questionnaires. Mean (SD) age of women accepting PPIUCD was 24 (4) years. Over half of women had parity of one, and nearly one-quarter had no formal schooling. Nearly all women (99.6%) reported that they were satisfied with IUCD at the time of insertion and 92% reported satisfaction at the six-week follow-up visit. The rate of expulsion of IUCD was 3.6% by six weeks of follow-up. There were large variations in rates of problems and complications that were largely attributable to the individual hospitals implementing the study. Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.

  7. Outcomes after intrauterine insemination are independent of provider type

    Science.gov (United States)

    Goldman, Randi H.; Batsis, Maria; Hacker, Michele R.; Souter, Irene; Petrozza, John C.

    2015-01-01

    OBJECTIVE We sought to determine whether the success of intrauterine insemination (IUI) varies based on the type of health care provider performing the procedure. STUDY DESIGN This was a retrospective cohort study set at an infertility clinic at an academic institution. The patients who comprised this study were 1575 women who underwent 3475 IUI cycles from late 2003 through early 2012. Cycles were stratified into 3 groups according to the type of provider who performed the procedure: attending physician, fellow physician, or registered nurse (RN). The primary outcome was live birth. Additional outcomes of interest included positive pregnancy test and clinical pregnancy. Repeated measures log binomial regression was used to estimate the risk ratios (RR) and 95% confidence intervals (CI) for the outcomes and to evaluate the effect of potential confounders. All tests were 2-sided, and P values < .05 were considered statistically significant. RESULTS Of the 3475 IUI cycles, 2030 (58.4%) were gonadotropin stimulated, 929 (26.7%) were clomiphene citrate stimulated, and 516 (14.9%) were natural. The incidences of clinical pregnancy and live birth among all cycles were 11.8% and 8.8%, respectively. After adjusting for female age, male partner age, and cycle type, the incidence of live birth was similar for RNs compared with attending physicians (RR, 0.80; 95% CI, 0.58–1.1) and fellow physicians compared with attending physicians (RR, 0.84; 95% CI, 0.58–1.2). Similar results were seen for positive pregnancy test and clinical pregnancy. CONCLUSION There was no significant difference in live birth following IUI cycles in which the procedure was performed by a fellow physician or RN compared with an attending physician. PMID:24881820

  8. Six-week retention after postplacental copper intrauterine device placement.

    Science.gov (United States)

    Colwill, Alyssa Covelli; Schreiber, Courtney A; Sammel, Mary D; Sonalkar, Sarita

    2018-03-01

    We sought to evaluate the 6-week clinical outcomes (intrauterine device [IUD] retention, recognized expulsions, ability to visualize or palpate strings, and need for ultrasound evaluation) in women who received a TCu380A postplacental IUD (PPIUD) after vaginal (VD) or cesarean delivery (CD). We conducted a retrospective cohort study to examine the 6-week retention of TCu380A IUDs placed within 10 min of placental delivery in VD (n=137) and CD (n=73). We used Student's t test and Wilcoxon rank sum tests for continuous data and Pearson χ 2 test and Fisher's Exact Test for categorical data. Of the 169 women who had follow-up, 151 (89.3%) retained their IUD at 6 weeks (95% CI 84.7%-93.9%). All women who underwent CD retained their IUD at 6 weeks postpartum (56/56), whereas 95/113 (84% [95% CI 76.0%-90.3%]) who underwent VD retained their original IUD (p<.01). Strings were detected more frequently in women who had a VD (93.1% [95% CI 85.6-97.4]) compared to those who delivered by CD (44.2% [95% CI 30.5-58.7]; p<.01). Women who underwent CD had an ultrasound to evaluate IUD location more frequently (42.9% [95% CI 29.7-56.8]) compared to women who underwent VD (13.7% [95% CI 7.5-22.3]; p<.01). Women are more likely to retain a PPIUD after CD compared to a VD (p<.01); however, women who have a PPIUD placed after CD are more likely to have nonvisible strings with a pelvic exam (p<.01) and undergo pelvic ultrasound evaluation (p<.01) compared to a PPIUD placed at the time of a VD. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Medications to ease intrauterine device insertion: a systematic review.

    Science.gov (United States)

    Zapata, Lauren B; Jatlaoui, Tara C; Marchbanks, Polly A; Curtis, Kathryn M

    2016-12-01

    Potential barriers to intrauterine device (IUD) use include provider concern about difficult insertion, particularly for nulliparous women. This study aims to evaluate the evidence on the effectiveness of medications to ease IUD insertion on provider outcomes (i.e., ease of insertion, need for adjunctive insertion measures, insertion success). We searched the PubMed database for peer-reviewed articles published in any language from database inception through February 2016. We included randomized controlled trials (RCTs) that examined medications to ease interval insertion of levonorgestrel-releasing IUDs and copper T IUDs. From 1855 articles, we identified 15 RCTs that met our inclusion criteria. Most evidence suggested that misoprostol did not improve provider ease of insertion, reduce the need for adjunctive insertion measures or improve insertion success among general samples of women seeking an IUD (evidence Level I, good to fair). However, one RCT found significantly higher insertion success among women receiving misoprostol prior to a second IUD insertion attempt after failed attempt versus placebo (evidence Level I, good). Two RCTs on 2% intracervical lidocaine as a topical gel or injection suggested no positive effect on provider ease of insertion (evidence Level I, good to poor), and one RCT on diclofenac plus 2% intracervical lidocaine as a topical gel suggested no positive effect on provider ease of insertion (evidence Level I, good). Limited evidence from two RCTs on nitric oxide donors, specifically nitroprusside or nitroglycerin gel, suggested no positive effect on provider ease of insertion or need for adjunctive insertion measures (evidence Level I, fair). Overall, most studies found no significant differences between women receiving interventions to ease IUD insertion versus controls. Among women with a recent failed insertion who underwent a second insertion attempt, one RCT found improved insertion success among women using misoprostol versus

  10. Loop electrosurgical excision procedure with an intrauterine device in place.

    Science.gov (United States)

    Bailey, Amelia P; Darracott, Mixon M

    2010-09-01

    Patients using an intrauterine device (IUD) who require a loop electrosurgical excision procedure (LEEP) for cervical dysplasia have traditionally had the IUD removed prior to the procedure. The only other options have been methods that lead to suboptimal sampling or risk cutting the strings. Our study suggests a procedure for performing the LEEP without removing the IUD, and review of the literature suggests that this method has not been reported before. The LEEP is performed using a conization electrode or a cone biopsy excisor. After noting that the IUD strings are of adequate length, a 0-polyglactin free tie is secured around the visible portion of the IUD strings without applying tension on the strings. A large, sterile absorbent-tipped applicator with a hollow handle becomes an 8 cm hollow plastic tube by removing the cotton tip with sterile scissors. The long end of the suture is threaded through the sterile tube. Without pulling on the IUD, the tube is then passed over the strings into the cervical canal approximately 2.5 cm to protect the strings from the excisor well into the cervical canal. Then, the LEEP is performed. After the specimen is removed, hemostasis can be obtained using a ball cautery electrode, keeping the protecting tube with the enclosed IUD strings out of the way. The tube is then carefully removed. The suture is now cut close to the polyglactin knot around the IUD strings, making certain not to shorten the IUD strings and making certain the visible length of the strings is the same as before the procedure. Ferric subsulfate is applied to the operative area to provide continued hemostasis. Follow-up for the LEEP is unchanged. This procedure may be performed on either levonorgestrel-releasing or copper IUDs. Copyright 2010 Mosby, Inc. All rights reserved.

  11. Are intrauterine growth restriction and preterm birth associated with dental caries?

    Science.gov (United States)

    Saraiva, Maria C D; Bettiol, Heliosa; Barbieri, Marco A; Silva, Antonio A

    2007-10-01

    To assess the association between two intrauterine growth restriction (IUGR) surrogates - IUGR [small for gestational age birth (SGA) and fetal growth restriction (FGR)] and preterm birth with dental caries. Data from the Third National Health and Nutritional Examination Survey (1988-1994) were used, including 2- to 5.9-year-old singletons (n = 3189). Dental caries was defined as presence of any teeth with dental caries (treated or untreated) and also as presence of at least two teeth with dental caries. Exposure variables were preterm birth (education of head of household, breastfeeding, and use of baby bottle. Separate statistical analyses were conducted for IUGR and for preterm birth through the estimation of prevalence ratio (PR), taking complex sampling design into consideration and adjusting for confounders. Sensitivity analysis was conducted including and excluding 2-year-old children and also with the two definitions of dental caries. In general, the inclusion of 2-year-old children and the case definition of presence of any teeth with dental caries biased the results toward the null, but with no major changes in the results. In bivariate analysis, SGA and FGR birth were both negatively but not significantly associated with dental caries while a significant positive association was found for preterm birth. Sensitivity analysis showed that the PR for preterm in bivariate analysis varied from 1.65 (95% CI 1.14-2.40) to 1.84 (95% CI 1.19-2.83). After adjusting for confounders, the PR for preterm birth varied from 1.38 (95% CI 1.00-1.89) to 1.64 (95% CI 1.22-2.20). After adjustment, the PR for SGA varied from 0.79 (95% CI 0.56-101) to 0.66 (95% CI 0.33-0.96). For children from 3 to 5.9 years old, the adjusted PR for FGR using the category 'none' as reference were mild (PR 1.10; 95% CI 0.76-1.58), moderate (PR 0.66; 95% CI 0.26-167), and severe (PR 0.59; 95% CI 0.36-0.99). These values for FGR were very similar for the other models using other classifications of

  12. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    Bijlenga, D.; Boers, K.E.; Birnie, E.; Mol, B.W.J.; Vijgen, S.C.M.; van der Post, J.A.M.; de Groot, C.J.; Rijnders, R.J.P.; Pernet, P.J.; Roumen, F.J.; Stigter, R.H.; Delemarre, F.M.C.; Bremer, H.A.; Porath, M.; Scherjon, S.A.; Bonsel, G.J.

    2011-01-01

    Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Growth Intervention Trial

  13. Morphometry of megakaryocytes in the liver of New Zealand White rabbits during intrauterine and postnatal development

    Directory of Open Access Journals (Sweden)

    Pacheco Maria Rita

    2002-01-01

    Full Text Available The hepatic megakaryocytic cells of New Zealand White rabbit in the intrauterine phase and in the immediate postnatal period were studied. Statistical analysis of the data concerning the cytoplasm and nucleus of those cells, i.e., area, perimeter, maximum diameter, minimum diameter, volume and shape factor, presented significant differences (p<0.01 for F values concerning the life phases studied on15th, 22nd and 29th day of intrauterine life and 10th day of postnatal life, and for F values for animal within each phase. The Tukey?s test showed that most of the parameters studied in the cytoplasm and nucleus of these megakaryocytic cells presented the lowest values on the 15th day of intrauterine life and the highest on the 22nd day of the same phase.

  14. Successful outcome with intrauterine transfusion in non-immune hydrops fetalis secondary to congenital syphilis.

    Science.gov (United States)

    Chen, Innie; Chandra, Sujata; Singh, Ameeta; Kumar, Manoj; Jain, Venu; Turnell, Roger

    2010-09-01

    Congenital syphilis is rare, but the incidence has increased over the last few years in Alberta. Previous reports of fetal hydrops secondary to syphilis are few and have not demonstrated the application of middle cerebral artery peak systolic velocity (MCA PSV) to monitor for fetal anemia, or reported successful management with intrauterine transfusion. A 17-year-old primigravida at 28 weeks' gestational age with positive syphilis serology and fetal hydrops was treated with high-dose intravenous penicillin. An elevated MCA PSV suggested fetal anemia. Successful intrauterine cordocentesis and transfusion of packed red blood cells led to resolution of fetal hydrops. The fetus delivered spontaneously at 35 weeks' gestation with no clinical signs of congenital syphilis. Syphilitic hydrops may be successfully managed with high dose intravenous penicillin, measurement of MCA PSV, and intrauterine transfusion.

  15. [Stab wounds of the hand and forearm due to Kuluna in Kinshasa (Democratic Republic of Congo): types of injuries and treatment].

    Science.gov (United States)

    Kibadi, K; Portaels, F; Pichot, Y; Kapinga, M; Moutet, F

    2015-01-01

    Democratic Republic of Congo (DRC), a particular form of juvenile delinquency and insecurity intensifies in the city of Kinshasa. This is the phenomenon Kuluna. It is organized gangs equipped with machetes and other weapons. The main objective of this study is to know the phenomenon Kuluna and describe the upper limb injuries caused by machetes, while insisting on the specifics of the management of these lesions in our communities. This retrospective descriptive study examines 14 cases of wounds of the hand and forearm due to stab phenomenon Kuluna, in Kinshasa. It covers the period from 1 November 2010 to 1 November 2013. Among the 14 patients with lesions in the hand and forearm admitted and treated at the Unit of Plastic Reconstructive and Aesthetic Surgery, Hand Surgery and Burns, University Clinics of Kinshasa to attacks due to the phenomenon Kuluna. We have 11 men and 3 women. The average age was 33, 5 years (extremes of 21 and 56 years). The right upper limb is reached that the left upper limb, respectively 12 patients and 2 patients. The lesions are localized to the wrist in the majority of cases (10 patients) in the palm of hand and in 3 patients in the fingers in 1 patient. The palmar surface is reached (10 cases) and the dorsal (4 cases). Zone 5 of the International Classification of flexor and Zone 8 topographic classification extensors at hand are the predilection sites of lesions respectively the palmar surface (6 out of 10) and the dorsal (2 case 4). The median nerve at the wrist is cut in half the cases. On bone lesions localized to the forearm, we observed a high incidence of fracture of the ulna (62.5%). The treatment begins with the stabilization of bone pieces, gestures revascularization and nerve sutures and suture tendon and finally skin coverage. Rehabilitation was mandatory, she supervises the actions of repair and it continues until the recovery of function.

  16. Effects of social stress and intrauterine position on sexual phenotype in wild-type house mice (Mus musculus)

    Science.gov (United States)

    William J. Zielinski; John G. Vandenbergh; Monica M. Montano

    1991-01-01

    Wild-type house mice were used to test the effect of intrauterine position on anogenital distance (AGD) and to verify whether crowding stress would masculinize female pups, developing at all intrauterine positions, as has been demonstrated in CF-1 mice stressed by restraint, heat, and...

  17. Is dilatation and curettage obsolete for diagnosing intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding?

    NARCIS (Netherlands)

    Emanuel, M. H.; Wamsteker, K.; Lammes, F. B.

    1997-01-01

    To determine the predictive value of dilatation and curettage (D&C) for diagnosing intrauterine disorders in patients with persistent abnormal uterine bleeding. An observational descriptive study was performed in a large university-affiliated teaching hospital. The suspicion of intrauterine

  18. SOWS FERTILITY AFTER TRANSCERVICAL INTRAUTERINE INSEMINATION (the sumarize of ours results

    Directory of Open Access Journals (Sweden)

    B. STANČIĆ

    2008-10-01

    Full Text Available We have investigated the potential advantages of transcervical artificial insemination into the caudal portion of the uterus (corpus uteri, compared with conventional sperm-dose deposition into the posterior region of the cervix. Three experiments was carried out to investigate: (1 the influence of insemination-dose volume, (2 sperm number per dose and (3 type of insemination catheter on sows fertility (farrowing rate and litter size. Classic intracervical insemination was performed in the total of 50 sows (25 inseminated with 100ml doses and 25 with 50ml doses. Intrauterine insemination was performed in the total of 50 sows (25 inseminated with 100ml doses and 25 with 50ml doses. Significant greater farrowing rate (88% and live born piglet per litter (10,77 or 11,86 was found after intrauterine insemination, then after intracervical insemination (76 or 72% farrowing rate, and 10,42 or 9,89 live born piglets per litter. Classic intracervical insemination was performed in the total of 90 sows, with different catheter type. Intrauterine insemination was performed in the total of 90 sows, with 5x109,3,7x109 or 2,5x109 spermatozoa per dose. No significant differences in farrowing rate was found between intracervical and intrauterine insemination (83,3 to 86,7%. Significant greater live born piglet per litter was found after intrauterine insemination with 2,5x109 spermatozoa per dose. Obtained results suggest that intrauterine insemination can be performed by significant reduction of insemination dose volume and sperm number in dose, without decreasing sows fertility. It can result in significant increasing of boar reproductive efficiency.

  19. A clinical and ultrasound study on the use of postplacental intrauterine device

    Directory of Open Access Journals (Sweden)

    João Henrique Araújo Fernandes

    2004-06-01

    Full Text Available Objective: To evaluate the relation of postplacental intrauterinedevice insertion immediately after vaginal delivery and cesareansection and its effects on the following: continuation, expulsionrate and eventual removals. To verify if ultrasound is an adequatemethod to follow-up postplacental IUD insertions. To assess if theimmediate insertion of postplacental IUD leads to an increasedrisk of uterine infections and perforations, or greater likelihood ofpregnancy during the observation period. Methods: A group of 50patients who had an intrauterine device introduced within tenminutes after delivery of the placenta were studied. Twenty-fivewomen had vaginal delivery and 25 had cesarean sections. Theintrauterine device used in this study was the Multiload CU 375,standard model, manufactured by Organon Ltd., in Ireland. Theintrauterine device was inserted in those who had vaginal deliveryeither manually and under anesthesia, or with an inserter, whichdid not require anesthesia. In patients who had cesarean sections,the insertion was manual. Clinical and ultrasound follow up wasperformed four times: 48 hours postpartum, and at 6, 12 and 24weeks. The distance from the top of the intrauterine device to theuterine fundus was measured by ultrasound. Results: This studyshowed a significant difference in postplacental intrauterinedevices inserted after vaginal deliveries and cesarean sections.The expulsion/removal rate was 32% among the subjects who hadan intrauterine device inserted after vaginal delivery. There wereno expulsions or removals in those submitted to cesarean sections.In the control ultrasound of intrauterine devices inserted aftervaginal delivery, at 6 weeks, the distance of 10 mm from the top ofthe device to the fundus was an average standard measurementto determine continuation (distance 10 mm,the IUD would be expelled or be removed. There were no cases ofuterine infections or perforations, and no pregnancies during thecourse of this study

  20. Head Injuries in Soccer.

    Science.gov (United States)

    Myrick, Karen M

    2016-07-01

    Soccer is currently the most popular and fastest growing sport worldwide, with approximately 265 million registered soccer players existing around the world. The popularity of the sport, coupled with the high incidence of 18.8-21.5 head injuries per 1,000 player hours reported, make it essential that clinicians, coaches, and the athletes, have a solid understanding of head injuries. The successful rehabilitation of athletes with head injuries relies upon early and accurate identification strategies and implementation of appropriate return to play measures across all areas in the continuum of care. Soccer is a frequently played sport, and head injuries are common. Therefore, it is imperative that clinicians, coaches, and the athletes themselves have a solid understanding of head injury prevention, diagnosis, and treatment options. The purpose of this article was to provide rehabilitation nurses with current information regarding frequently occurring head injuries in the widespread sport of soccer. © 2015 Association of Rehabilitation Nurses.

  1. Head and Neck

    DEFF Research Database (Denmark)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-01-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques......, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories....

  2. Accuracy of information about the intrauterine device on the Internet.

    Science.gov (United States)

    Madden, Tessa; Cortez, Sarah; Kuzemchak, Marie; Kaphingst, Kimberly A; Politi, Mary C

    2016-04-01

    Intrauterine devices (IUDs) are highly effective methods of contraception, but use continues to lag behind less effective methods such as oral contraceptive pills and condoms. Women who are aware of the actual effectiveness of various contraceptive methods are more likely to choose the IUD. Conversely, women who are misinformed about the safety of IUDs may be less likely to use this method. Individuals increasingly use the Internet for health information. Information about IUDs obtained through the Internet may influence attitudes about IUD use among patients. Our objective was to evaluate the quality of information about IUDs among World Wide Web sites providing contraceptive information to the public. We developed a 56-item structured questionnaire to evaluate the quality of information about IUDs available through the Internet. We then conducted an online search to identify web sites containing information about contraception and IUDs using common search engines. The search was performed in August 2013 and web sites were reviewed again in October 2015 to ensure there were no substantial changes. Our search identified >2000 web sites, of which 108 were eligible for review; 105 (97.2%) of these sites contained information about IUDs. Of sites, 86% provided at least 1 mechanism of the IUD. Most web sites accurately reported advantages of the IUD including that it is long acting (91%), highly effective (82%), and reversible (68%). However, only 30% of sites explicitly indicated that IUDs are safe. Fifty percent (n = 53) of sites contained inaccurate information about the IUD such as an increased risk of pelvic inflammatory disease beyond the insertion month (27%) or that women in nonmonogamous relationships (30%) and nulliparous women (20%) are not appropriate candidates. Among sites, 44% stated that a mechanism of IUDs is prevention of implantation of a fertilized egg. Only 3% of web sites incorrectly stated that IUDs are an abortifacient. More than a quarter of

  3. New Approaches to Treatment of Severe Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Zhanar Kurmangali

    2014-12-01

    Full Text Available Introduction. Intrauterine growth restriction (IUGR is a leading cause of perinatal morbidity and mortality due to placental insufficiency. Currently, one of the new approaches to treating this disease is the injection of nutrients to the fetus through intravascular port-systems (catheters.Objective. To assess the impact of nutrient injections as treatment to fetuses with severe growth retardation.Materials and methods. Pregnant women with IUGR (abdominal circumference (AC < 5th percentile with the absence of diastolic flow in the umbilical artery and a fetal gestational age of less than 30 weeks were randomly divided into two groups. The treatment group included six pregnant women who had an intravascular port-system for the infusion of nutrients (amino acids and glucose in the umbilical vein of the fetus for 14 ± 3 days. The control group consisted of eight patients who received only traditional dynamic monitoring and delivery at the optimum time of pregnancy. Fetal status was assessed using ultrasound equipment Accuvix V20 (Medison, South Korea by examining indicators of biometry and Doppler study of blood flow in utero, umbilical arteries, middle cerebral artery, and ductus venosus with fetal vascular resistance index calculation - pulsatility index (PI. Criteria for blood flow disturbances in the vessels were considered PI values above normal values for their gestational age, which were defined as absence or reverse blood flow in a diastole in the umbilical artery.Results. In a comparative analysis of the two groups, the treatment led to a 44.7% increase in AC of the fetus (121.0 ± 11.5 mm and 219.3 ± 18.3 mm, respectively, p ˂ 0.001. In all cases, the profile of blood flow in the umbilical artery had a positive diastolic component. As a result, there was a 45.3% decrease in PI in the umbilical artery (2.14 ± 0.54 and 1.17 ± 0.15, respectively, p < 0.05. Average fetal weight in the study group was not significantly higher than the

  4. Bottom head assembly

    International Nuclear Information System (INIS)

    Fife, A.B.

    1998-01-01

    A bottom head dome assembly is described which includes, in one embodiment, a bottom head dome and a liner configured to be positioned proximate the bottom head dome. The bottom head dome has a plurality of openings extending there through. The liner also has a plurality of openings extending there through, and each liner opening aligns with a respective bottom head dome opening. A seal is formed, such as by welding, between the liner and the bottom head dome to resist entry of water between the liner and the bottom head dome at the edge of the liner. In the one embodiment, a plurality of stub tubes are secured to the liner. Each stub tube has a bore extending there through, and each stub tube bore is coaxially aligned with a respective liner opening. A seat portion is formed by each liner opening for receiving a portion of the respective stub tube. The assembly also includes a plurality of support shims positioned between the bottom head dome and the liner for supporting the liner. In one embodiment, each support shim includes a support stub having a bore there through, and each support stub bore aligns with a respective bottom head dome opening. 2 figs

  5. Intrauterine insemination versus intracervical insemination in donor sperm treatment.

    Science.gov (United States)

    Kop, Petronella Al; Mochtar, Monique H; O'Brien, Paul A; Van der Veen, Fulco; van Wely, Madelon

    2018-01-25

    The first-line treatment in donor sperm treatment consists of inseminations that can be done by intrauterine insemination (IUI) or by intracervical insemination (ICI). To compare the effectiveness and safety of intrauterine insemination (IUI) and intracervical insemination (ICI) in women who start donor sperm treatment. We searched the Cochrane Gynaecology and Fertility Group Trials Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL in October 2016, checked references of relevant studies, and contacted study authors and experts in the field to identify additional studies. We searched PubMed, Google Scholar, the Grey literature, and five trials registers on 15 December 2017. We included randomised controlled trials (RCTs) reporting on IUI versus ICI in natural cycles or with ovarian stimulation, and RCTs comparing different cointerventions in IUI and ICI. We included cross-over studies if pre-cross-over data were available. We used standard methodological procedures recommended by Cochrane. We collected data on primary outcomes of live birth and multiple pregnancy rates, and on secondary outcomes of clinical pregnancy, miscarriage, and cancellation rates. We included six RCTs (708 women analysed) on ICI and IUI in donor sperm treatment. Two studies compared IUI and ICI in natural cycles, two studies compared IUI and ICI in gonadotrophin-stimulated cycles, and two studies compared timing of IUI and ICI. There was very low-quality evidence; the main limitations were risk of bias due to poor reporting of study methods, and serious imprecision.IUI versus ICI in natural cyclesThere was insufficient evidence to determine whether there was any clear difference in live birth rate between IUI and ICI in natural cycles (odds ratio (OR) 3.24, 95% confidence interval (CI) 0.12 to 87.13; 1 RCT, 26 women; very low-quality evidence). There was only one live birth in this study (in the IUI group). IUI resulted in higher clinical pregnancy rates (OR 6.18, 95% CI 1.91 to 20.03; 2

  6. Head Injuries in Children

    Science.gov (United States)

    Pennington, Nicole

    2010-01-01

    School nurses play a crucial role in injury prevention and initial treatment when injuries occur at school. The role of school nurses includes being knowledgeable about the management of head injuries, including assessment and initial treatment. The school nurse must be familiar with the outcomes of a head injury and know when further evaluation…

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Computed tomography (CT) of the head uses special x-ray equipment to help assess head injuries, severe headaches, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  8. Paediatric outcomes following intrauterine exposure to serotonin reuptake inhibitors: a systematic review

    DEFF Research Database (Denmark)

    Fenger-Grøn, Jesper; Thomsen, Morten; Andersen, Kristian Skytte

    2011-01-01

    and persistent pulmonary hypertension of the new-born, while evidence regarding the risk of preterm labour, low birth weight, low Apgar score, prolonged QT interval and miscarriage is less clear. An estimated 20-30% of infants will have neonatal symptoms following intrauterine SRI exposure. The symptoms may...

  9. M ultiple Organ Failure Followed by Intrauterine Klebsiella Pneumoniae Infection Associated with Diabetes M ellitus

    OpenAIRE

    Nagai, Takashi; Inoue, Chiharu; Tonouchi, Kazunori; Tonooka, Naoko; Imamura, Makoto; Kaneko, Katumi; Honma, Manabu

    2009-01-01

    A 49-year-old semi-conscious woman was admitted due to fever and dehydration. Disseminatedintravascular coagulation (DIC), renal dysfunction and diabetic ketoacidosis were detected. Wholebody computed tomography showed multiple nodular lesions in bilateral lungs and kidneys indicatingseptic emboli, and intrauterine lesions. We diagnosed multiple organ failure followed by intrauterineinfection due to untreated diabetes mellitus. Vaginal discharge and blood culture revealed Klebsiellapneumoniae...

  10. Intrauterine insemination or intracervical insemination with cryopreserved donor sperm in the natural cycle : a cohort study

    NARCIS (Netherlands)

    Kop, P. A. L.; van Wely, M.; Mol, B. W.; de Melker, A. A.; Janssens, P. M. W.; Arends, B.; Curfs, M. H. J. M.; Kortman, M.; Nap, A.; Rijnders, E.; Roovers, J. P. W. R.; Ruis, H.; Simons, A. H. M.; Repping, S.; van der Veen, F.; Mochtar, M. H.

    STUDY QUESTION: Does intrauterine insemination in the natural cycle lead to better pregnancy rates than intracervical insemination (ICI) in the natural cycle in women undergoing artificial insemination with cryopreserved donor sperm. SUMMARY ANSWER: In a large cohort of women undergoing artificial

  11. Umbilical hypercoiling in 2nd- and 3rd-trimester intrauterine fetal death

    NARCIS (Netherlands)

    Dutman, Annemiek C.; Nikkels, Peter G J

    2015-01-01

    Cases of unexplained intrauterine fetal death (IUFD) can be reduced by full placental examination, with or without autopsy. Determination of the umbilical coiling index (UCI) is considered to be a part of full placental examination. Umbilical hypercoiling (UCI above 0.30 coils/cm) is associated with

  12. Predictors of ovarian response in intrauterine insemination patients and development of a dosage nomogram

    DEFF Research Database (Denmark)

    Freiesleben, N L C; Lossl, K; Bogstad, J

    2008-01-01

    The objective of this prospective study was to identify predictors of ovarian response in ovulatory patients treated with low-dose recombinant FSH (rFSH), gonadotrophin-releasing hormone antagonist and intrauterine insemination (IUI), and to develop an rFSH dosage nomogram based on the findings...

  13. Long-term impact of perinatal bereavement. Comparison of grief reactions after intrauterine versus neonatal death

    NARCIS (Netherlands)

    Schaap, A. H.; Wolf, H.; Bruinse, H. W.; Barkhof-van de Lande, S.; Treffers, P. E.

    1997-01-01

    OBJECTIVE: To investigate possible differences in emotional impact on parents following either a deliberate intrauterine death or a neonatal death in extremely preterm growth retarded infants. DESIGN: Retrospectively matched study by audiotaped semi-structured interview, 3-9 years after the

  14. [Uterovesical perforation secondary to intrauterine device with vesical lithiasis formation: a report of two cases].

    Science.gov (United States)

    Insausti Jaca, N; Urresola Olabarrieta, A; Ibáñez, S; Atilano Santos, L; Aguinaga Alexanco, A; Larrea Bilbao, L

    2007-01-01

    Uterovesical perforation is an uncommon complication in patients with intrauterine devices (IUD). When this complication occurs, intravesical lithiasis is often associated. We present two cases of uterovesical perforation with a description of the radiological findings and a review of the literature.

  15. Bladder stone caused by an ectopic intrauterine contraceptive device: case report

    International Nuclear Information System (INIS)

    Atasoy, C.; Fitoz, S.; Akyar, S.

    2001-01-01

    Perforation of the uterus is a recognized complication associated with the use of an intrauterine contraceptive (IUCD). However, migration of an IUCD into the bladder, with or without stone formation, is exceptionally rare. We report the case of a patient with a displaced IUCD that acted as a nidus for bladder lithiasis. (author)

  16. Bladder stone caused by an ectopic intrauterine contraceptive device: case report

    Energy Technology Data Exchange (ETDEWEB)

    Atasoy, C.; Fitoz, S.; Akyar, S. [Ankara Univ. School of Medicine, Dept. of Radiology, Ibn-i Sina Hospital, Ankara (Turkey)

    2001-02-01

    Perforation of the uterus is a recognized complication associated with the use of an intrauterine contraceptive (IUCD). However, migration of an IUCD into the bladder, with or without stone formation, is exceptionally rare. We report the case of a patient with a displaced IUCD that acted as a nidus for bladder lithiasis. (author)

  17. Immunohistochemical structural pecularities of uterine tube of fetuses with signs of intrauterine infection

    Directory of Open Access Journals (Sweden)

    Лариса Сергеевна Куприянова

    2015-05-01

    Full Text Available Aim - immunohistochemical detection of structural features of the uterine tubes of fetuses with signs of intrauterine infection.Methods: anthropometric, macroscopic, organometric, histological, immunohistochemical, statistical.Object of research - the uterine tubes of antenatal dead fetuses. The control group consisted of 25 fetuses of healthy mothers; the comparison group is 15 fetuses with signs of intrauterine infection. Fetal infection confirmed by laboratory methods; the presence of TORCH infections, cytomegalovirus, herpes infection and chlamydial infection is determined.Results: indicators of weight and body length of the fetus of the comparison group were significantly reduced. Unidirectional changes are established in the definition of the mass and the length of the uterine tubes of fetuses with signs of intrauterine infection. Massive growth of connective tissue in the mucosa, the mucous membrane and muscle membrane of wall of the uterine tube of fetus in the comparison group is shown by histological methods. Violation of collagen formation in the connective tissue in the uterine tubes of fetuses with signs of intrauterine infection is found by immunohistochemistry method.Conclusions: The reduction of anthropometric and organometric indicators in fetuses of comparison group is shown. Sclerosis and atrophy, as well as violations of collagen-synthesizing function are predominated in the main structural components of the wall of the uterine tube of fetuses in the comparison group. The revealed changes in the future ontogenesis may lead to the development of primary infertility

  18. Timing of insertion of levonorgestrel-releasing intrauterine system : a randomised controlled trial

    NARCIS (Netherlands)

    van der Heijden, Pahh; Geomini, Pmaj; Herman, M C; Veersema, S; Bongers, M Y

    OBJECTIVE: The objective was to assess whether patient-perceived pain during the insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) depends on the timing during the menstrual cycle. DESIGN: A stratified two-armed non-inferiority randomised controlled trial. SETTING: Large

  19. Intrauterine contraception: the role of general practitioners in four Dutch general practices.

    NARCIS (Netherlands)

    Vos, A.A.; Veldhuis, H.M.; Lagro-Janssen, A.L.M.

    2004-01-01

    The intrauterine device (IUD) use in the Netherlands and the United States is limited to a small group of women, though the risk of infection and pregnancy is small. Therefore, it was of interest to investigate the characteristics of women who choose an IUD as contraceptive method and the influence

  20. Use of the Copper T380A intrauterine device by adolescent mothers: continuation and method failure.

    Science.gov (United States)

    Patchen, Loral; Berggren, Erica K

    2011-04-01

    This report contributes to limited empirical data regarding use of the Copper T380A intrauterine device among adolescent mothers. We conducted a retrospective case series of adolescent mothers aged 15 to 21 years whose index delivery occurred before age 18 and met study inclusion criteria. All adolescent mothers received obstetrics and gynecology care at one urban clinical site in Washington, DC. All participated in a teen secondary pregnancy prevention program from April 2002 to November 2008 and used the Copper T380A intrauterine device. We abstracted data to evaluate intrauterine device utilization, expulsion, removal, and pregnancy diagnosis. Thirty-nine adolescent mothers met inclusion criteria. Six patients had partial or complete expulsion (15%; 95% CI, 6-29), and 10 requested removal (26%; 95% CI, 14-41) within 24 months of placement. Four users (10%; 95% CI, 3-23) became pregnant. Three had an intrauterine device in place at time of conception, while one became pregnant due to unrecognized device expulsion. In this case series, many adolescent mothers discontinued Copper T380A use within two years of placement. The numbers of patients were too limited to provide stable estimates of contraceptive effectiveness. Larger comparative studies will further evaluate both effectiveness and acceptability of this device among teen mothers. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. Exploring Trends in Intrauterine Device (IUD) Usage among Women in the United States: A Literature Review

    Science.gov (United States)

    Nobiling, Brandye; Drolet, Judy C.

    2012-01-01

    Intrauterine devices (IUDs) have not been popular contraceptives in the US for the past 40 years. Recent evidence, however, has shown a slight rebirth in use, from a rate of approximately 2% in 2002 to over 5% in 2008 (Guttmacher Institute, 2010). Empirical evidence is favorable of IUD use in most women, but the still-low usage rate suggests…

  2. Perforation of the Rectum by a Copper-T Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Intrauterine contraceptive devices are among the most effective forms of contraceptives available. They provide long term reversible protection from pregnancy and are currently the most popular and widely use reversible contraceptive method. Though they are associated with few side effects, perforation of the uterus ...

  3. A prospective study on intrauterine cannabis exposure and fetal blood flow

    NARCIS (Netherlands)

    Marroun, H. el; Tiemeier, H.; Steegers, E.A.P.; Roos-Hesselink, J.W.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; Brink, W. van den; Huizink, A.C.

    2010-01-01

    Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded in the

  4. Pretreatment with Misoprostol Reduces Intrauterine Adhesions After Surgical Termination of Missed Abortion

    Directory of Open Access Journals (Sweden)

    Sedat Akgöl

    2012-08-01

    CONCLUSION: Misoprostol reduces intrauterine adhesions after surgical termination of missed abortion, possibly by improving the convenience of curettage. Pretreatment with misoprostol can be justified for women who have history of infertility or recurrent pregnancy loss and who are to undergo curettage.

  5. The Probable Effects of Cytokines in Intrauterine Infections and Perinatal Brain Injury

    Directory of Open Access Journals (Sweden)

    Mehmet Oflaz

    2013-10-01

    Full Text Available Perinatal brain injuries and the subsequent development of cerebral palsy are closely associated with intrauterine infections and inflammatory response. Premature prenatal rupture of membranes and premature births are also closely linked to infections and inflammation, and the presence of both infection / inflammation and premature birth together greatly increase the risk for cerebral palsy. Periventricular leukolamacia, a common neonatal brain white matter lesion, is a major risk factor for cerebral palsy. Inflammatory cytokines released during the course of intrauterine infection play an important role in the genesis of brain white matter lesion. Maternal intrauterine infection appears to increase the risk of preterm delivery, which in turn is associated with an increased risk of intraventricular hemorrhage, neonatal white matter damage, and subsequent cerebral palsy. Proinflammatory cytokines IL-1, IL-6 and Tumor necrosis factor-%u03B1 might be the link between prenatal intrauterine infection and neonatal brain damage, and interrupting the proinflammatory cytokine cascade might prevent later disability in those born near the end of the second trimester.

  6. Does measurement of intrauterine pressure have predictive value during oxytocin-augmented labor?

    NARCIS (Netherlands)

    Mol, Ben Willem J.; Logtenberg, Sabine L. M.; Verhoeven, Corine J. M.; Bloemenkamp, Kitty W. M.; Papatsonis, Dimitri N. M.; Bakker, Jannet J. H.; van der Post, Joris A. M.

    2016-01-01

    In a previous randomized trial that compared monitoring uterine contractions with an intrauterine pressure catheter (IUPC) versus external monitoring, we demonstrated that use of an IUPC did not improve the outcome of labor. To provide insight in the lack of a positive effect, we evaluated level of

  7. Pre- and postnatal imaging of Pai syndrome with spontaneous intrauterine closure of a frontal cephalocele

    Energy Technology Data Exchange (ETDEWEB)

    Dobrocky, Tomas; Ebner, Lukas; Stranzinger, Enno [Inselspital University Hospital, University of Bern, Department of Interventional, Pediatric and Diagnostic Radiology, Bern (Switzerland); Liniger, Benjamin [Inselspital University Hospital, University of Bern, Department of Pediatric Surgery, Bern (Switzerland); Weisstanner, Christian [Inselspital University Hospital, University of Bern, Department of Diagnostic and Interventional Neuroradiology, Bern (Switzerland)

    2015-06-15

    Pai syndrome is a rare congenital disorder characterized by cutaneous polyps of the face, pericallosal lipoma and median cleft lip. We report on a newborn girl with a variant of Pai syndrome presenting with all typical findings except a median cleft. In addition, fetal sonography and MRI showed the unique intrauterine evolution of a cephalocele into an atretic cephalocele. (orig.)

  8. Simultaneous use of a levonorgestrel intrauterine system and an etonogestrel subdermal implant for debilitating adolescent endometriosis.

    Science.gov (United States)

    Al-Jefout, Moamar; Palmer, John; Fraser, Ian S

    2007-06-01

    Adolescent familial endometriosis may cause severe and persistent symptoms that are disruptive to lifestyle. Treatment may be difficult in many cases. We describe the novel and successful first use of a simultaneous combination of a levonorgestrel intrauterine system and an etonogestrel subdermal implant in a teenager with severe pain symptoms as a result of laparoscopically confirmed endometriosis, which was refractory to other treatments.

  9. The hepatic transcriptome of young suckling and aging intrauterine growth restricted male rats.

    Science.gov (United States)

    Freije, William A; Thamotharan, Shanthie; Lee, Regina; Shin, Bo-Chul; Devaskar, Sherin U

    2015-04-01

    Intrauterine growth restriction leads to the development of adult onset obesity/metabolic syndrome, diabetes mellitus, cardiovascular disease, hypertension, stroke, dyslipidemia, and non-alcoholic fatty liver disease/steatohepatitis. Continued postnatal growth restriction has been shown to ameliorate many of these sequelae. To further our understanding of the mechanism of how intrauterine and early postnatal growth affects adult health we have employed Affymetrix microarray-based expression profiling to characterize hepatic gene expression of male offspring in a rat model of maternal nutrient restriction in early and late life. At day 21 of life (p21) combined intrauterine and postnatal calorie restriction treatment led to expression changes in circadian, metabolic, and insulin-like growth factor genes as part of a larger transcriptional response that encompasses 144 genes. Independent and controlled experiments at p21 confirm the early life circadian, metabolic, and growth factor perturbations. In contrast to the p21 transcriptional response, at day 450 of life (d450) only seven genes, largely uncharacterized, were differentially expressed. This lack of a transcriptional response identifies non-transcriptional mechanisms mediating the adult sequelae of intrauterine growth restriction. Independent experiments at d450 identify a circadian defect as well as validate expression changes to four of the genes identified by the microarray screen which have a novel association with growth restriction. Emerging from this rich dataset is a portrait of how the liver responds to growth restriction through circadian dysregulation, energy/substrate management, and growth factor modulation. © 2014 Wiley Periodicals, Inc.

  10. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study.

    LENUS (Irish Health Repository)

    Unterscheider, Julia

    2013-04-01

    The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile.

  11. A prospective study on intrauterine cannabis exposure and fetal blood flow

    NARCIS (Netherlands)

    El Marroun, H.; Tiemeier, H.; Steegers, E.A.P.; Roos-Hesselink, J.W.; Jaddoe, V.W.V.; Hofman, A.; Verhulst, F.C.; van den Brink, W.; Huizink, A.C.

    2010-01-01

    Background: Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded

  12. A prospective study on intrauterine cannabis exposure and fetal blood flow

    NARCIS (Netherlands)

    El Marroun, Hanan; Tiemeier, Henning; Steegers, Eric A. P.; Roos-Hesselink, Jolien W.; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; van den Brink, Wim; Huizink, Anja C.

    2010-01-01

    Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. This study was embedded in the Generation R Focus

  13. Trunnion-Head Stresses in THA: Are Big Heads Trouble?

    Science.gov (United States)

    Lavernia, Carlos J; Iacobelli, David A; Villa, Jesus M; Jones, Kinzy; Gonzalez, Jose L; Jones, William Kinzy

    2015-06-01

    The effects of large heads on stresses at the THA trunnion-head junction and their impact on tribocorrosion/metal ion release remain controversial. A 12/14 3D-model of a stem with different head sizes was investigated. Material properties of titanium were assigned to the trunnion and cobalt-chrome/alumina to the heads. A load simulating walking single-leg stand phase was applied to the head. A total contact head-trunnion interface was assumed. The area underneath the junction underwent significant elevations in stresses as head size increased from 28- to 40-mm. Maximum principal stress doubled between 28 and 40-mm heads, regardless of head material. Stress levels had a direct correlation to head diameter. Stress increases observed using increasingly larger heads will probably contribute to head-trunnion tribocorrosion and ion release. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial.

    Science.gov (United States)

    Turok, David K; Leeman, Lawrence; Sanders, Jessica N; Thaxton, Lauren; Eggebroten, Jennifer L; Yonke, Nicole; Bullock, Holly; Singh, Rameet; Gawron, Lori M; Espey, Eve

    2017-12-01

    Immediate postpartum levonorgestrel intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterine device insertion on breast-feeding outcomes. We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery feeding. We conducted per-protocol analysis as the primary approach, as it is considered the standard for noninferiority studies; we also report the alternative intent-to-treat analysis. We powered the study for the primary outcome, breast-feeding continuation at 8 weeks, to detect a 15% noninferiority margin between groups, requiring 132 participants in each arm. The secondary study outcome, time to lactogenesis, used a validated measure, and was analyzed by survival analysis and log rank test. We followed up participants for ongoing data collection for 6 months. Only the data analysis team was blinded to the intervention. We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate group (79%; 95% confidence interval, 70-86%) was noninferior to that of the delayed group (84%; 95% confidence interval, 76-91%). The 5% difference in breast-feeding continuation at 8 weeks between the

  15. Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: a cluster randomized trial.

    Science.gov (United States)

    Thompson, Kirsten M J; Rocca, Corinne H; Stern, Lisa; Morfesis, Johanna; Goodman, Suzan; Steinauer, Jody; Harper, Cynthia C

    2018-03-23

    US unintended pregnancy rates remain high, and contraceptive providers are not universally trained to offer intrauterine devices and implants to women who wish to use these methods. We sought to measure the impact of a provider training intervention on integration of intrauterine devices and implants into contraceptive care. We measured the impact of a continuing medical education-accredited provider training intervention on provider attitudes, knowledge, and practices in a cluster randomized trial in 40 US health centers from 2011 through 2013. Twenty clinics were randomly assigned to the intervention arm; 20 offered routine care. Clinic staff participated in baseline and 1-year surveys assessing intrauterine device and implant knowledge, attitudes, and practices. We used a difference-in-differences approach to compare changes that occurred in the intervention sites to changes in the control sites 1 year later. Prespecified outcome measures included: knowledge of patient eligibility for intrauterine devices and implants; attitudes about method safety; and counseling practices. We used multivariable regression with generalized estimating equations to account for clustering by clinic to examine intervention effects on provider outcomes 1 year later. Overall, we surveyed 576 clinic staff (314 intervention, 262 control) at baseline and/or 1-year follow-up. The change in proportion of providers who believed that the intrauterine device was safe was greater in intervention (60% at baseline to 76% at follow-up) than control sites (66% at both times) (adjusted odds ratio, 2.48; 95% confidence interval, 1.13-5.4). Likewise, for the implant, the proportion increased from 57-77% in intervention, compared to 61-65% in control sites (adjusted odds ratio, 2.57; 95% confidence interval, 1.44-4.59). The proportion of providers who believed they were experienced to counsel on intrauterine devices also increased in intervention (53-67%) and remained the same in control sites (60

  16. Accuracy of Computed Tomography in Diagnosis of Intra-abdominal Injuries in Stable Patients with Anterior Abdominal Stab Wounds: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Baron, Bonny J; Benabbas, Roshanak; Kohler, Casey; Biggs, Carina; Roudnitsky, Valery; Paladino, Lorenzo; Sinert, Richard

    2018-01-25

    Work-up for patients presenting to the Emergency Department (ED) following an anterior abdominal stab wound (AASW) has been debated since the 1960s. Experts agree that patients with peritonitis, evisceration, or hemodynamic instability should undergo immediate laparotomy (LAP), however, workup of stable, asymptomatic or non-peritoneal, patients is not clearly defined. To evaluate the accuracy of computed tomography of abdomen and pelvis (CTAP) for diagnosis of intra-abdominal injuries requiring Therapeutic Laparotomy (THER-LAP) in ED patients with AASW. Is a negative CT scan without a period of observation sufficient to safely discharge a hemodynamically stable, asymptomatic AASW patient? We searched PUBMED, EMBASE, and Scopus from their inception until May 2017 for studies on ED patients with AASW. We defined the reference standard test as LAP for patients who were managed surgically and those with THER-LAP were considered as disease-positive. In those who were managed nonsurgically, inpatient observation was considered the reference standard. We used the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) to evaluate the risk of bias and applicability of the included studies. We attempted to compute the pooled sensitivity, specificity, Likelihood Ratios (LR+, LR-) using a random-effects model with MetaDiSc software and calculate testing and treatment thresholds for CT scan applying the Pauker and Kassirer model. Seven studies were included encompassing 575 patients. The weighted prevalence of THER-LAP was 34.3% (95% CI 30.5-38.2%). Studies had variable quality and the inclusion criteria were not uniform. The operating characteristics of CT scan were: sensitivity 50%-100%, specificity 39%-97%, LR+ 1.0-15.7 and LR- 0.07-1.0. The high heterogeneity (I-square>75%) of the operating characteristics of CT scan prevented pooling of the data and therefore the testing and treatment thresholds could not be estimated. The articles revealed a high prevalence (8

  17. A levonorgestrel-releasing intrauterine system embedded in the omentum in a woman with abdominal pain: a case report

    Directory of Open Access Journals (Sweden)

    Phillips Kevin

    2009-11-01

    Full Text Available Abstract Introduction The Mirena intrauterine system has been licensed as a contraceptive in the United Kingdom since May 1995. The use of an intrauterine system as a primary method of contraception among women has been slowly increasing over the last few years and they now account for about 3% of contraceptive use in England. The Mirena intrauterine system now also has a license for the management of idiopathic menorrhagia. Women may be informed that the rate of uterine perforation associated with intrauterine contraceptive use is low (0-2.3 per 1000 insertions. The rate of perforation reported with the Mirena intrauterine system in a large observational cohort study was 0.9 per 1000 insertions. Case presentation In this case report, the diagnosis of an intraperitoneal Mirena intrauterine system was noted nearly four years after its insertion, despite the patient having had a vaginal hysterectomy and admissions to hospital in the interim with complaints of abdominal pain. Conclusion This case report demonstrates clearly that whenever there is a question of a intrauterine system having fallen out following an ultrasound scan report showing an empty uterus, clinicians should also perform an abdominal X-ray.

  18. Impact of HBV replication in peripheral blood mononuclear cell on HBV intrauterine transmission.

    Science.gov (United States)

    Shi, Xiaohong; Wang, Xuefei; Xu, Xixi; Feng, Yongliang; Li, Shuzhen; Feng, Shuying; Wang, Bo; Wang, Suping

    2017-12-01

    This study determined the effect of hepatitis B virus (HBV) replication in peripheral blood mononuclear cell (PBMC) from HBsAg-positive mothers on HBV intrauterine transmission. A total of 150 HBsAg-positive mothers and their neonates were recruited in this study. Within 24 h after birth, HBV serological markers, serum HBV DNA, PBMC HBV relaxed circular DNA (rcDNA), and covalently closed circular DNA (cccDNA) were measured in the HBsAg-positive mothers and their neonates before passive-active immune prophylaxis. The relationship between HBV replication in PBMC and HBV intrauterine transmission was examined through Chisquare test and logistic regression. The rate of HBV intrauterine transmission was 8.00% (12/150) in the 150 neonates born to HBsAg-positive mothers. The positivities of PBMC HBV rcDNA and cccDNA in the HBsAg-positive mothers were 36.67% (55/150) and 10% (15/150), respectively. Maternal PBMC HBV cccDNA was a risk factor of HBV intrauterine transmission (OR = 6.003, 95% CI: 1.249-28.855). Maternal serum HBeAg was a risk factor of PBMC HBV rcDNA (OR = 3.896, 95% CI: 1.929-7.876) and PBMC HBV cccDNA (OR = 3.74, 95% CI: 1.186-11.793) in the HBsAg-positive mothers. Administration of hepatitis B immune globulin was a protective factor of PBMC HBV cccDNA (OR = 0.312, 95%CI: 0.102-0.954) during pregnancy. The positivity of PBMC HBV rcDNA was related to that of cccDNA in the HBsAg-positive mothers (χ 2 = 5.087, P = 0.024). This study suggests that PBMC is a reservoir of HBV and an extrahepatic site for virus replication and plays a critical role in HBV intrauterine transmission.

  19. The state of immunity in pregnancies complicated by intrauterine infection of the fetus.

    Science.gov (United States)

    Shcherbina, Nikolay A; Vygivska, Liudmyla А

    2017-01-01

    To study the state of immunity in pregnancies associated with urogenital infection and complicated by intrauterine infection. The comparative study involved the examination of 250 pregnant women with urogenital infection and ultrasonographic signs of intrauterine infection and their newborns in order to assess the state of cellular and humoral immunity components and nonspecific resistance. A direct prospective examination of pregnant women was carried out in the 2nd and 3rd trimesters of gestation. Depending on the outcome of each pregnancy on the basis of the follow-up of newborns, performed on the first day after birth, the patients were retrospectively divided into two groups. The study group included 93 (37.2%) pregnant women who developed intrauterine infection. The comparison group (n=157 (62.8%)) comprised pregnant-carriers of perinatally significant infection who gave birth to conditionally healthy children. The control group consisted of 50 healthy women with a physiological pregnancy. In the gestation period under investigation, the development of intrauterine infection in pregnant women with urogenital infections was found to be associated with a deficiency of T-helpers / inducers, an increase in thymus-dependent lymphocyte killer activity, a high content of IL-1β, TNF-α in the systemic circulation, and a decrease in the level of IL-10 secondary to the oppression of the effector link of phagocytic neutrophils of peripheral blood. An increased concentration of systemic proinflammatory cytokines IL-1β, IL-6 and TNFα with a simultaneous decrease in the IL-10 content and suppression of the killing activity of peripheral blood phagocytes reflects the presence of an active inflammatory process in the mother-placenta-fetus system and can be one of the factors affecting the development of intrauterine infection in pregnancy, complicated by urogenital infection.

  20. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer ... there any new developments in treating my disease? Head and neck cancer overview The way a particular ...

  1. American Head and Neck Society

    Science.gov (United States)

    American Head & Neck Society Mission Statement: Advance Education, Research, and Quality of Care for the head and neck oncology patient. American Head & Neck Society | AHNS The mission of the AHNS is to ...

  2. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive ... of page What are some common uses of the procedure? MR imaging of the head is performed ...

  3. Head injuries in sport.

    Science.gov (United States)

    Cantu, R C

    1996-12-01

    Injuries to the head and neck are the most frequent catastrophic sports injury, and head injuries are the most common direct athletic cause of death. Although direct compressive forces may injure the brain, neural tissue is particularly susceptible to injury from shearing stresses, which are most likely to occur when rotational forces are applied to the head. The most common athletic head injury is concussion, which may very widely in severity. Intracranial haemorrhage is the leading cause of head injury death in sports, making rapid initial assessment and appropriate follow up mandatory after a head injury. Diffuse cerebral swelling is another serious condition that may be found in the child or adolescent athlete, and the second impact syndrome is a major concern in adult athletes. Many head injuries in athletes are the result of improper playing techniques and can be reduced by teaching proper skills and enforcing safety promoting rules. Improved conditioning (particularly of the neck), protective headgear, and careful medical supervision of athletes will also minimise this type of injury.

  4. Femoral head avascular necrosis

    International Nuclear Information System (INIS)

    Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

    1988-01-01

    MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... used to detect: bleeding, brain injury and skull fractures in patients with head injuries. bleeding caused by ... be asked to remove hearing aids and removable dental work. Women will be asked to remove bras ...

  6. TCGA head Neck

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  7. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... microphone. top of page How does the procedure work? In many ways CT scanning works very much ... head CT scanning. Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 ...

  8. Head Start Impact Study

    Data.gov (United States)

    U.S. Department of Health & Human Services — Nationally representative, longitudinal information from an evaluation where children were randomly assigned to Head Start or community services as usual;direct...

  9. Early Head Start Evaluation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

  10. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It ... within the brain shortly after a patient exhibits symptoms of a stroke. a stroke, especially with a ...

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Survey Do you have a personal story about radiology? Share your patient story here Images × Image Gallery ... Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... special x-ray equipment to help assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, ... cancer. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ...

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... special computer program processes this large volume of data to create two-dimensional cross-sectional images of ...

  14. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... scans in children should always be done with low-dose technique. top of page What are the ... page Additional Information and Resources RTAnswers.org Radiation Therapy for Brain Tumors Radiation Therapy for Head and ...

  15. Overview of Head Injuries

    Science.gov (United States)

    ... kept in the emergency department or hospital for observation. Children who have had a minor head injury ... penetrating trauma (such as a knife or gunshot wound). Injuries may range from relatively small hematomas (collections ...

  16. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... rays). top of page What are some common uses of the procedure? CT scanning of the head ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ...

  17. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It also helps your doctor ... scanning provides more detailed information on head injuries, stroke , brain tumors and other brain diseases than regular ...

  18. Unprotected intercourse in the 2 weeks prior to requesting emergency intrauterine contraception.

    Science.gov (United States)

    Sanders, Jessica N; Howell, Laura; Saltzman, Hanna M; Schwarz, E Bimla; Thompson, Ivana S; Turok, David K

    2016-11-01

    Previous emergency contraception studies have excluded women who report >1 episode of unprotected or underprotected intercourse. Thus, clinical recommendations are based on exposure to a single episode of underprotected intercourse. We sought to assess the prevalence and timing of underprotected intercourse episodes among women requesting emergency contraception and to examine the probability of pregnancy following an emergency contraception regimen including placement of either a copper intrauterine device or a levonorgestrel intrauterine device with simultaneous administration of an oral levonorgestrel pill in women reporting multiple underprotected intercourse episodes, including episodes beyond the Food and Drug Administration-approved emergency contraception time frame (6-14 days). Women seeking emergency contraception who had a negative pregnancy test and desired either a copper intrauterine device or levonorgestrel emergency contraception regimen enrolled in this prospective observational study. At enrollment, participants reported the number and timing of underprotected intercourse episodes in the previous 14 days. Two weeks later, participants reported the results of a self-administered home pregnancy test. Of the 176 women who presented for emergency contraception and received a same-day intrauterine device, 43% (n = 76) reported multiple underprotected intercourse episodes in the 14 days prior to presenting for emergency contraception. Women with multiple underprotected intercourse episodes reported a median of 3 events (range 2-20). Two-week pregnancy data were available for 172 (98%) participants. Only 1 participant had a positive pregnancy test. Pregnancy occurred in 0 of 97 (0%; 95% confidence interval, 0-3.7%) women with a single underprotected intercourse episode and 1 of 75 (1.3%; 95% confidence interval, 0-7.2%) women reporting multiple underprotected intercourse episodes; this includes 1 of 40 (2.5%; 95% confidence interval, 0-13.2%) women

  19. Transgenerational Glucose Intolerance of Tumor Necrosis Factor with Epigenetic Alteration in Rat Perirenal Adipose Tissue Induced by Intrauterine Hyperglycemia.

    Science.gov (United States)

    Su, Rina; Yan, Jie; Yang, Huixia

    2016-01-01

    Changes in DNA methylation may play a role in the genetic mechanism underlying glucose intolerance in the offspring of mothers with diabetes. Here, we established a rat model of moderate intrauterine hyperglycemia induced by streptozotocin to detect glucose and lipid metabolism of first-generation (F1) and second-generation (F2) offspring. Moderate intrauterine hyperglycemia induced high body weight in F1 and F2 offspring of diabetic mothers. F1 offspring had impaired glucose tolerance and abnormal insulin level. Additionally, F1 and F2 offspring that were exposed to intrauterine hyperglycemia had impaired insulin secretion from the islets. The tumor necrosis factor (Tnf) gene was upregulated in perirenal adipose tissue from F1 offspring and relatively increased in F2 offspring. Both F1 and F2 offspring showed similar hypomethylation level at the -1952 site of Tnf. We confirmed that DNA methylation occurs in offspring exposed to intrauterine hyperglycemia and that the DNA methylation is intergenerational and inherited.

  20. Uterine Perforation with the Levonorgestrel-Releasing Intrauterine Device Analysis of Reports from Four National Pharmacovigilance Centres

    NARCIS (Netherlands)

    van Grootheest, Kees; Sachs, Bernhardt; Harrison-Woolrych, Mira; Caduff-Janosa, Pia; van Puijenbroek, Eugene

    2011-01-01

    Background: Levonorgestrel-releasing intrauterine devices (LNG-IUD) are commonly used for contraception and other indications in many countries. National pharmacovigilance centres have been receiving reports from healthcare professionals and patients of uterine perforation associated with the use of

  1. Immediate postpartum versus 6-week postpartum intrauterine device insertion: a feasibility study of a randomized controlled trial.

    Science.gov (United States)

    Bryant, Amy G; Kamanga, Gift; Stuart, Gretchen S; Haddad, Lisa B; Meguid, Tarek; Mhango, Chisale

    2013-06-01

    This study aimed to evaluate the feasibility of conducting a randomized controlled trial of postpartum intrauterine device insertion and to demonstrate that the postpartum intrauterine device is acceptable to women. Women attending prenatal care at a maternity hospital in Lilongwe, Malawi were recruited into a trial comparing immediate (10 minutes to 48 hours) to 6 week postpartum insertion. Feasibility of recruiting and consenting 140 women and randomizing 70% of them was evaluated. Satisfaction with the intrauterine device was also assessed. One hundred fifteen women consented and 49 (61%) were randomized. Twenty-six women were assigned to immediate insertion, and 23 to insertion at 6 weeks postpartum. Thirty (24%) women received the device as part of the study protocol, and 28 (93%) had the device in place at 12 weeks postpartum. The intrauterine device is acceptable to some postpartum women in Malawi, but conducting a randomized clinical trial may not be feasible.

  2. Treatment of dysfunctional uterine bleeding: patient preferences for endometrial ablation, a levonorgestrel-releasing intrauterine device, or hysterectomy

    NARCIS (Netherlands)

    Bourdrez, Petra; Bongers, Marlies Y.; Mol, Ben W. J.

    2004-01-01

    OBJECTIVE: To investigate patient preferences for endometrial ablation and a levonorgestrel-releasing intrauterine device (IUD) as alternatives to hysterectomy in the treatment of dysfunctional uterine bleeding. DESIGN: Comparative study based on structured interviews. SETTING: A large teaching

  3. Effect of the copper-intrauterine device (TCu 380A) on subendometrial microvascularization and uterine artery blood flow.

    Science.gov (United States)

    Jiménez, Mirela F; Passos, Eduardo P; Fagundes, Paulo A P; de Freitas, Fernando M; Arbo, Elisangela; Cunha-Filho, João S L

    2006-12-01

    During this cohort study, the copper-intrauterine device (IUD) did not modify subendometrial microvascularization. However, subendometrial blood flow increased in patients who experienced IUD-induced side effects.

  4. A randomized, multi-center, clinical trial to assess the efficacy and safety of alginate carboxymethylcellulose hyaluronic acid compared to carboxymethylcellulose hyaluronic acid to prevent postoperative intrauterine adhesion.

    Science.gov (United States)

    Kim, Tak; Ahn, Ki Hoon; Choi, Doo Seok; Hwang, Kyung Joo; Lee, Byoung Ick; Jung, Min Hyung; Kim, Jae Weon; Kim, Jong Hyuk; Cha, Sun Hee; Lee, Ki Hwan; Lee, Kyu Sup; Oh, Sung Tack; Cho, Chi Heum; Rhee, Jeong Ho

    2012-01-01

    To estimate the efficacy of alginate carboxymethylcellulose hyaluronic acid (ACH) gel to prevent intrauterine adhesions after hysteroscopic surgery in comparison with carboxymethylcellulose hyaluronic acid (CH) gel, which is known as an effective adhesion inhibitor. Randomized, multicenter, single-blind, clinical trial (Canadian Task Force classification I). Tertiary university hospital. One hundred eighty-seven patients with a surgically treatable intrauterine lesion (myomas, polyps, septa, intrauterine adhesion, dysfunctional uterine bleeding). Patients were randomized to 2 groups: hysteroscopic surgery plus intrauterine application of ACH or CH. The rate of adhesion formation and the adhesion severity score with type and extent were calculated 4 weeks after surgery. The ACH group had results that were comparable to the CH group in terms of the development of intrauterine adhesions at 4 weeks follow-up. The adhesion severities were not different between the 2 groups. In a subgroup without baseline intrauterine adhesion, the ACH group showed a lower intrauterine adhesion rate than the CH group (p = .016). ACH had a comparable efficacy to CH in terms of the adhesion rate and severity. In the case of no baseline intrauterine adhesion, intrauterine application of ACH after hysteroscopic surgery had a lower rate of intrauterine adhesion than application of CH. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

  5. Specific features of a neonatal period in infants following intrauterine intravascular blood transfusion for fetal hemolytic disease

    Directory of Open Access Journals (Sweden)

    A. V. Ivanova

    2015-01-01

    Full Text Available The paper gives data on the characteristics of a neonatal period in infants following intrauterine blood transfusion for Rh-induced fetal hemolytic disease. It is shown that the early diagnosis and detection of the signs of fetal hemolytic disease, and intrauterine intravascular blood transfusion may prolong pregnancy, ensure the birth of a baby with normal anthropometric indicators, optimize his/her neonatal period and prognosis of severe hemolytic disease in the fetus and newborn.

  6. Comparison of placebo and intrauterine lidocaine with/or without rectal diclofenac sodium suppositories used in office endometrial biopsy.

    Science.gov (United States)

    Kaya, Cengiz; Sener, Elif Bengi; Koksal, Ersin; Ustun, Yasemin Burcu; Celik, Handan; Sahinoglu, Ali Haydar

    2015-01-01

    To compare the effects of intrauterine lidocaine, intrauterine lidocaine plus rectal diclofenac, and a placebo on analgesia and to determine the satisfaction of patients and surgeons in cases of endometrial biopsy. The double-blind, randomised, placebo-controlled study was conducted in the Department of Obstetrics and Gynaecology of the Ondokuz Mayis University, Samsun,Turkey, from April 2013 to January 2014, and comprised patients scheduled for in-office endometrial biopsy.They were divided into three groups: Group P, 5ml of 0.9% saline intrauterine; Group L, 5ml of 2% lidocaine intrauterine; and Group LD, 5ml of 2% lidocaine intrauterine ± 10min before the procedure plus 50mg of rectal diclofenac sodium. Haemodynamic changes and visual analogue scale scores were recorded during the preoperative period, when the cervix was grasped with a tenaculum, immediately after intrauterine instillation, during uterine curettage and at postoperative 10 min. The patient and the surgeon were questioned about their satisfaction 15 min after the procedure. SPSS 21 was used for statistical analysis. The 90 patients in the study were divided into three equal groups of 30(33.33%) each. There were no statistically significant inter-group differences in age, bodyweight, parity, number of postmenopausal patients, haemodynamic parameters and American Society of Anesthesiologists scores (p>0.05 in all categories). In Group P, the visual analogue scale score estimated when the cervix was grasped with the tenaculum was lower when compared with Group L and Group LD (p=0.029 and p=0.007, respectively). At other measurement time points, the scores did not differ between the groups. The groups did not differ with respect to patient and surgeon satisfaction and complication rates (p>0.05). Intrauterine lidocaine or intrauterine lidocaine plus rectal diclofenac application had no effect on visual analogue scale scores, patient satisfaction and vasovagal reaction.

  7. Effect of Sperm Morphology on Pregnancy Success via Intrauterine Insemination: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kohn, Taylor P; Kohn, Jaden R; Ramasamy, Ranjith

    2017-11-09

    Men with abnormal sperm morphology are often counseled that natural conception and intrauterine insemination are ineffective, and in vitro fertilization is the only option. Our objective was to determine the effect of sperm morphology on the pregnancy success of intrauterine insemination. We systematically searched for studies published prior to January 2017 that 1) reported ultrasound verified clinical pregnancies per intrauterine insemination cycle, 2) assessed sperm morphology using the kruger strict criteria and 3) described morphology at the greater than 4% and 4% or less and/or the 1% or greater and less than 1% thresholds. In all studies mean female age was between 25 and 40 years and mean total motile sperm count was greater than 10 million. Estimates were pooled using random effects meta-analysis. Data were extracted from 20 observational studies involving a total of 41,018 cycles. When comparing men at the greater than 4% and 4% or less thresholds, the rate of ultrasound verified pregnancy per intrauterine insemination cycle was not statistically or clinically different (14.2% vs 12.1%, p = 0.06) and the risk difference was 3.0% (95% CI 1.4-4.6), indicating 3.0 additional pregnancies per 100 intrauterine insemination cycles. When comparing men at the 1% or greater and the less than 1% thresholds, there were no statistical or clinical differences in the rate of ultrasound verified pregnancy per cycle of intrauterine insemination (14.0% vs 13.9%, p = 0.97) or in the risk difference (1.6%, 95% CI -4.5-7.6). There appears to be no clinical difference in intrauterine insemination pregnancy success among men with normal and abnormal sperm morphology when accounting for total motile sperm count and female age. Abnormal sperm morphology alone should not exclude couples from attempting intrauterine insemination. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Intra-uterine experimental infection by Ureaplasma diversum induces TNF-α mediated womb inflammation in mice

    OpenAIRE

    Silva,Jamile R.; Ferreira,Lício F.A.A.; Oliveira,Percíllia V.S.; Nunes,Ivanéia V.; Pereira,Ítalo S.; Timenetsky,Jorge; Marques,Lucas M.; Figueiredo,Tiana B.; Silva,Robson A.A.

    2016-01-01

    Ureaplasma diversum is an opportunistic pathogen associated with uterine inflammation, impaired embryo implantation, infertility, abortions, premature birth of calves and neonatal pneumonia in cattle. It has been suggested that the intra-uterine infection by Ureaplasma diversum can cause vascular changes that hinder the success of pregnancy. Thus, the aim of this study was to evaluate the changes of intrauterine site of A/J mice in estrus or proestrus phase inoculated with Ureaplasma diversum...

  9. Expanding Access to the Intrauterine Device in Public Health Facilities in Ethiopia: A Mixed-Methods Study

    Science.gov (United States)

    Tilahun, Yewondwossen; Mehta, Sarah; Zerihun, Habtamu; Lew, Candace; Brooks, Mohamad I; Nigatu, Tariku; Hagos, Kidest Lulu; Asnake, Mengistu; Tasissa, Adeba; Ali, Seid; Desalegn, Ketsela; Adane, Girmay

    2016-01-01

    ABSTRACT In Ethiopia, modern contraceptive prevalence among currently married women nearly tripled over the last decade, but the method mix remains skewed toward short-acting methods. Since 2011, the Integrated Family Health Program (IFHP+), jointly implemented by Pathfinder International and John Snow Inc., has supported the Federal Ministry of Health to introduce intrauterine devices (IUDs) in more than 800 health centers across 4 regions to improve access to a wider range of methods. Between March and August 2014, Pathfinder conducted a mixed-methods study in 40 purposively selected health centers to assess shifts in the contraceptive method mix following introduction of IUDs using data from family planning registers; determine the characteristics of IUD users through a cross-sectional survey of 2,943 family planning clients who accepted the IUD; explore reasons for method discontinuation among 165 clients seeking IUD removal services; and identify facilitators and barriers to IUD use through focus group discussions (N = 115 clients) and key informant interviews (N = 36 providers, facility heads, and health office heads). Introduction of IUDs into the 40 health centers participating in the study was correlated with a statistically significant increase in the contribution of all long-acting reversible contraceptives (LARCs)—both IUDs and implants—to the method mix, from 6.9% in 2011 to 20.5% in 2014 (P<.001). Our study found that latent demand for the IUD was more prevalent than anticipated and that the method was acceptable to a broad cross-section of women. Of the 2,943 women who sought IUDs during the 6-month study period, 18.0% were new contraceptive users (i.e., those using a contraceptive method for the first time ever), 44.7% reported no educational attainment, 62.5% were from rural areas, and 59.3% were younger than 30 years old, with almost 3 in 10 (27.7%) under the age of 25. The most commonly cited reason for seeking IUD removal services

  10. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

  11. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head ... limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is ...

  12. Analysis of morbidity of children irradiated intrauterine as a result of the Chernobyl accident

    International Nuclear Information System (INIS)

    Sychik, S.I.; Stozharov, A.N.

    1999-01-01

    The purpose of the investigation was analysis of the influence of intrauterine irradiation of radioactive iodine on the structure and dynamics of prenatal irradiated children morbidity. It was examined children's group ( 10 years old aged ) irradiated in intrauterine status and having been lived constantly on polluted by radionuclide area of the Stolyn District of the Brest Region with contamination density of caesium 137 up to 15 Ci/km 2 . Control group were children aged 9 years old born after the accident and lived constantly in the same points that prenatal irradiated. The observation of morbidity since 1987 to 1995 years has shown that among prenatal irradiated children were more high parameters of general and primary morbidity in the structure of morbidity. It was established that thyroid gland participated in the forming of pathology of other organs and systems

  13. Premature delivery due to intrauterine Candida infection that caused neonatal congenital cutaneous candidiasis: a case report.

    Science.gov (United States)

    Ito, Fumitake; Okubo, Tomoharu; Yasuo, Tadahiro; Mori, Taisuke; Iwasa, Koichi; Iwasaku, Kazuhiro; Kitawaki, Jo

    2013-01-01

    Congenital cutaneous candidiasis is a very rare disease with less than 100 cases published in the medical literature. Neonates having this disease present with systemic skin lesions caused by intrauterine Candida infections. We present a case of threatened premature delivery due to Candida chorioamnionitis, which caused both maternal postpartum endometritis and neonatal congenital cutaneous candidiasis. A 34-year-old woman who was admitted for fetal membrane bulging at 20 weeks of gestation underwent McDonald cervical cerclage. We diagnosed threatened premature delivery due to intrauterine infection; therefore, we terminated the gestation by cesarean section at 24 weeks of gestation. Fungi-like yeast was detected in infantile gastric juice. Histopathological findings of the placenta revealed that Candida albicans mycelium invaded the placenta, chorioamniotic membrane and umbilical cord. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  14. Do plain plastic and copper bearing intrauterine contraceptive devices have a central mechanism of action?

    Science.gov (United States)

    Goldstuck, N D

    1987-06-01

    The notion that the intrauterine contraceptive device (IUCD) has a central, as well as a local action, is examined. Although the IUCD undoubtedly has a local action, certain IUCD related side effects, e.g. galactorrhoea, bloating and premenstrual syndrome and inadequate luteal function can be explained if the IUCD has some central action. The powerful postcoital anti-fertility effect of both copper-bearing and plain plastic IUCDs probably also depends to some extent on a central action. The central action of the IUCD is probably due to initiation of reflex hypothalamic activity following intrauterine reflex stimulation. The hypothalamic response to IUCD insertion consists of release of beta-endorphin accompanied by raised levels of prolactin, vasopressin and oxytocin.

  15. The echoic pseudogestational sac of ectopic pregnancy simulating early intrauterine pregnancy.

    Science.gov (United States)

    Schaffer, R M; Stein, K; Shih, Y H; Goodman, J D

    1983-05-01

    The sonographic features of ectopic pregnancy have been well documented. When an early intrauterine pregnancy is identified or an obvious extrauterine sac is visualized, diagnosis is not a problem; but often a sac is seen within the uterus that may contain a well-defined rind and even internal echoes simulating an early fetal pole. This has been mistaken for an early intrauterine pregnancy. In this review, four patients with pseudogestational sacs had internal echoes within the sac, and two of them ultimately underwent dilatation and curettage, which revealed blood clots. This supports the assertion that fetal cardiac activity and/or fetal motion should be demonstrated within a fetal pole before the diagnosis of ectopic pregnancy is excluded.

  16. THE COURSE OF THE EARLY NEONATAL PERIOD OF LIFE IN NEWBORNS WITH INTRAUTERINE GROWTH RETARDATION

    Directory of Open Access Journals (Sweden)

    L. V. Kozlova

    2017-01-01

    Full Text Available Based on the complex clinical and anamnestic, laboratory, instrumental examination, a number of aspects of the health status of children born in the outcome of physiologically occurring and complicated pregnancies in practically healthy mothers (including delayed development of the fetus and without it, as well as in mothers with aggravated somatic and gynecological anamnesis. The intrauterine growth retardation was associated with cerebral ischaemia of I-II degrees of severity, toxic erythema, polycythemia, hypoglycaemia, prolapse of the anterior mitral valve leaf, limited and less sympathetic activity, tension of depleted compensatory resources, acceleration of atrio-ventricular conduction, lower frequency of contractile and impaired relaxation functions of the myocardium. As a result of the work, the criteria for early diagnosis of health disorders in term infants with intrauterine growth retardation were determined. The features of the course of the early neonatal period of life, adaptation, and the state of the vegetative nervous and cardiovascular systems are proved.  

  17. Secondary Vesical Calculus Resulting from Migration of an Intrauterine Contraceptive Device

    Directory of Open Access Journals (Sweden)

    Suvarna Vagholkar

    2012-01-01

    Full Text Available Intrauterine contraceptive device (IUCD is the commonest form of contraception used in view of less systemic side effects. However, there are a multitude of local complications caused by it. Of all the local complications described, migration of the device into adjacent organs is the most morbid of all complications. A patient presenting with history of loss or disappearance of the intrauterine contraceptive device accompanied by urinary symptoms should raise the doubt of a migrated device with the formation of a secondary calculus. This prompts further radiological investigations and merits surgical intervention either endourologically or by open surgery depending upon the merits of the case. A case report elucidating this fact is presented.

  18. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H

    2009-01-01

    OBJECTIVE: To assess the diagnostic value of transvaginal sonographic (TVS) measurement of endometrial thickness for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding (AUB). METHODS: A random selection from the Danish Civil Registration System was made: 1660 women...... aged 20-74 years were invited to participate and 686 women were eligible and accepted inclusion (429 pre- and 257 postmenopausal). The women underwent TVS measurement of endometrial thickness and saline contrast sonohysterography (SCSH). Hysteroscopic resection with histopathology (gold standard...... modulators (n = 2). Thus, 375 women without AUB were included (217 pre- and 158 postmenopausal). Receiver-operating characteristics (ROC) curves for endometrial thickness and focal lesion were analyzed. RESULTS: Focal intrauterine pathology was confirmed in 41 women (35 with polyps, five with submucosal...

  19. Do Endometrial Movements Affect The Achievement of Pregnancy during Intrauterine Insemination?

    Directory of Open Access Journals (Sweden)

    Ari Kim

    2015-02-01

    Full Text Available Background: This study was aimed to assess the effect of endometrial movements on pregnancy achievement in intrauterine insemination (IUI cycles. Materials and Methods: The population of this observational study was composed of unexplained infertility couples undergoing first-time IUI with clomiphene citrate between September 2010 and October 2011. Not only endometrial movements, but also thickness, volume, pattern, and echogenic change of endometrium were analyzed prospectively in prediction of pregnancy. Results: The total number of 241 cycles of IUI with 49 intrauterine pregnancies (20.3% was analyzed. Pregnancy was not related to endometrial thickness and endometrial volume, but significantly related to endometrial movements associated with the number of contraction, strong movement, cervicofundal direction, and hyperechoic change (p<0.05. Pregnant group showed higher cervicofundal movement rate (89.8 vs. 75.5%. Conclusion: For IUI cycles stimulated by clomiphene citrate in unexplained infertility women, endometrial movements on the day of IUI could be a predictor of pregnancy.

  20. Optical coherence tomography of macular atrophy associated with microcephaly and presumed intrauterine Zika virus infection

    Directory of Open Access Journals (Sweden)

    Adriana Gondim de Moura Campos

    Full Text Available ABSTRACT This case report describes the retinal optical coherence tomography (OCT findings in a microcephalic infant with macular atrophy presumably caused by intrauterine Zika virus infection. OCT demonstrated atrophy of the outer retinal layers and choriocapillaris, including the outer nuclear layer and ellipsoid zone, associated with retinal pigment epithelium hyper-reflectivity and increased OCT penetration into deeper layers of the choroid and sclera. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with the Zika virus. It is becoming increasingly difficult to ignore the upsurge in congenital microcephaly observed in Brazil. Recently, ocular findings in infants with microcephaly associated with intrauterine Zika virus infection have been described. This is the first report of OCT imaging of macular atrophy in a child with presumed Zika virus infection-associated microcephaly.

  1. Cardiac Development and Transcription Factors: Insulin Signalling, Insulin Resistance, and Intrauterine Nutritional Programming of Cardiovascular Disease

    Science.gov (United States)

    Govindsamy, Annelene; Naidoo, Strinivasen

    2018-01-01

    Programming with an insult or stimulus during critical developmental life stages shapes metabolic disease through divergent mechanisms. Cardiovascular disease increasingly contributes to global morbidity and mortality, and the heart as an insulin-sensitive organ may become insulin resistant, which manifests as micro- and/or macrovascular complications due to diabetic complications. Cardiogenesis is a sequential process during which the heart develops into a mature organ and is regulated by several cardiac-specific transcription factors. Disrupted cardiac insulin signalling contributes to cardiac insulin resistance. Intrauterine under- or overnutrition alters offspring cardiac structure and function, notably cardiac hypertrophy, systolic and diastolic dysfunction, and hypertension that precede the onset of cardiovascular disease. Optimal intrauterine nutrition and oxygen saturation are required for normal cardiac development in offspring and the maintenance of their cardiovascular physiology. PMID:29484207

  2. Cardiovascular Disease Risk in the Offspring of Diabetic Women: The Impact of the Intrauterine Environment

    Science.gov (United States)

    Marco, Laura J.; McCloskey, Kate; Vuillermin, Peter J.; Burgner, David; Said, Joanne; Ponsonby, Anne-Louise

    2012-01-01

    The incidence of gestational diabetes is increasing worldwide, exposing large numbers of infants to hyperglycaemia whilst in utero. This exposure may have a long-term negative impact on the cardiovascular health of the offspring. Novel methods to assess cardiovascular status in the neonatal period are now available—including measuring arterial intima-media thickness and retinal photography. These measures will allow researchers to assess the relative impact of intrauterine exposures, distinguishing these from genetic or postnatal environmental factors. Understanding the long-term impact of the intrauterine environment should allow the development of more effective health policy and interventions to decrease the future burden of cardiovascular disease. Initiating disease prevention aimed at the developing fetus during the antenatal period may optimise community health outcomes. PMID:23133443

  3. Effect of perioperative fetal intrauterine hypoxia on maternal oxidative stress injury after cesarean section

    Directory of Open Access Journals (Sweden)

    Xue-Hong Zou

    2017-03-01

    Full Text Available Objective: To study the effect of perioperative fetal intrauterine hypoxia on maternal oxidative stress injury after cesarean section. Methods: 37 puerperae receiving cesarean section for fetal intrauterine hypoxia between May 2014 and December 2016 were selected as hypoxia group and 40 puerperae receiving cesarean section during the same period and without complications during pregnancy or fetal intrauterine hypoxia were selected as control group. Umbilical arterial blood was collected after delivery of placenta for blood gas analysis, and the placenta tissue and serum samples were collected to test the content of oxidative stress products and antioxidants. Results: Umbilical arterial blood gas analysis parameters pH value as well as PO2, HCO3 - and BE content of hypoxia group were significantly lower than those of control group (P<0.05; NADPH, reactive oxide species (ROS and reactive nitrogen species (RNS content in placenta tissue of hypoxia group were significantly higher than those of control group (P <0.05 while glutathione S-transferase (GST, glutathione peroxidase (GPx, superoxide dismutase (SOD, Trx, vitamin C (VitC, VitE and coenzyme Q10 (CoQ10 content were significantly lower than those of control group (P<0.05; serum malondialdehyde (MDA and 8-iso-prostaglandin F2α (8-iso-PGF2α content of hypoxia group were significantly higher than those of control group (P<0.05. Conclusions: Perioperative fetal intrauterine hypoxia can lead to maternal oxidative stress injury after cesarean section and increase the generation of free radicals and the consumption of antioxidants.

  4. Small for Gestational Age and Magnesium: Intrauterine magnesium deficiency may induce metabolic syndrome in later life

    OpenAIRE

    Junji Takaya

    2015-01-01

    Magnesium deficiency during pregnancy as a result of insufficient or low intake of magnesium is common in developing and developed countries. Previous reports have shown that intracellular magnesium of cord blood platelets is lower among small for gestational age (SGA) groups than that of appropriate for gestational age (AGA) groups, suggesting that intrauterine magnesium deficiency may result in SGA. Additionally, the risk of adult-onset diseases such as insulin resistance syndrome is greate...

  5. Non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methods.

    Science.gov (United States)

    Bahamondes, Luis; Valeria Bahamondes, M; Shulman, Lee P

    2015-01-01

    Most contraceptive methods present benefits beyond contraception; however, despite a large body of evidence, many healthcare professionals (HCPs), users and potential users are unaware of those benefits. This review evaluates the evidence for non-contraceptive benefits of hormonal and non-hormonal contraceptive methods. We searched the medical publications in PubMed, POPLINE, CENTRAL, EMBASE and LILACS for relevant articles, on non-contraceptive benefits of the use of hormonal and intrauterine reversible contraceptive methods, which were published in English between 1980 and July 2014. Articles were identified using the following search terms: 'contraceptive methods', 'benefits', 'cancer', 'anaemia', 'heavy menstrual bleeding (HMB)', 'endometrial hyperplasia', 'endometriosis' and 'leiomyoma'. We identified, through the literature search, evidence that some combined oral contraceptives have benefits in controlling HMB and anaemia, reducing the rate of endometrial, ovarian and colorectal cancer and ectopic pregnancy as well as alleviating symptoms of premenstrual dysphoric disorder. Furthermore, the use of the levonorgestrel-releasing intrauterine system also controls HMB and anaemia and endometrial hyperplasia and cancer, reduces rates of endometrial polyps in users of tamoxifen and alleviates pain associated with endometriosis and adenomyosis. Depot medroxyprogesterone acetate controls crises of pain associated with sickle cell disease and endometriosis. Users of the etonogestrel-releasing contraceptive implant have the benefits of a reduction of pain associated with endometriosis, and users of the copper intrauterine device have reduced rates of endometrial and cervical cancer. Despite the high contraceptive effectiveness of many hormonal and intrauterine reversible contraceptive methods, many HCPs, users and potential users are concerned mainly about side effects and safety of both hormonal and non-hormonal contraceptive methods, and there is scarce information

  6. Role of peripheral blood mononuclear cell transportation from mother to baby in HBV intrauterine infection.

    Science.gov (United States)

    Shao, Qingliang; Zhao, Xiaxia; Yao Li, M D

    2013-12-01

    We aimed to investigate the role of peripheral blood mononuclear cell transportation from mother to baby in hepatitis B virus (HBV) intrauterine infection. Thirty HBsAg-positive pregnant women in the second trimester and their aborted fetuses were included in this study. Enzyme-linked-immunosorbent-assay was utilized to detect HBsAg in the peripheral blood of pregnant women and the femoral vein blood of their aborted fetuses. HBV-DNA in serum and peripheral blood mononuclear cells (PBMC) and GSTM1 alleles of pregnant women and their aborted fetuses were detected by nested polymerase chain reaction (PCR) and seminested PCR, respectively. We also examined the location of placenta HBsAg and HBcAb using immunohistochemical staining. The expression of placenta HBV-DNA was detected by in situ hybridization. For the 30 aborted fetuses, the HBV intrauterine infection rate was 43.33%. The HBV-positive rates of HBsAg in peripheral blood, serum, and PBMC were 10% (3/30), 23.33% (7/30), and 33.33% (10/30), respectively. Maternal-fetal PBMC transport was significantly positively correlated with fetal PBMC HBV-DNA (P = 0.004). Meanwhile, the rates of HBV infection gradually decreased from the maternal side to the fetus side of placenta (decidual cells > trophoblastic cells > villous mesenchymal cells > villous capillary endothelial cells). However, no significant correlation between placenta HBV infection and HBV intrauterine infection was observed (P = 0.410). HBV intrauterine infection was primarily due to peripheral blood mononuclear cell maternal-fetal transportation in the second trimester in pregnant women.

  7. Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial.

    Science.gov (United States)

    Mercier, Rebecca J; Liberty, Abigail

    2014-12-01

    To determine if intrauterine administration of 5 cc of 2% lidocaine in addition to paracervical block reduces pain during laminaria insertion, when compared with paracervical block and saline placebo. This was a randomized, double blind placebo-controlled trial. Women presenting for abortion by dilation and evacuation (D&E) at 14-24 weeks gestational age were randomized to receive an intrauterine instillation of either 5 mL of 2% lidocaine or 5 mL of normal saline, in addition to standard paracervical block with 20 cc of 0.25% bupivacaine. Our primary outcome was self-reported pain scores on a 100mm Visual Analogue Scale (VAS) immediately following laminaria insertion. Secondary outcome was self-reported VAS pain score indicating the maximum level of pain experienced during the 24-48-h interval between laminaria insertion and D&E procedure. Seventy-two women were enrolled, and data for 67 women were analyzed, only two of whom were more than 21 weeks on gestation. The range of pain scores at both time points was large (1-90 mm at laminaria insertion; 0-100mm in laminaria-D&E interval). Mean pain scores were not different between treatment groups at laminaria insertion, (33 vs. 32, p=.8) or in the laminaria - D&E interval (43 vs. 44, p=.9). Intrauterine administration of 5 cc of 2% lidocaine in addition to paracervical block did not reduce pain with laminaria insertion when compared to paracervical block with saline placebo. Intrauterine lidocaine combined with paracervical block does not improve pain control at laminaria insertion when compared with paracervical block and saline placebo. Wide variation in pain scores and persistent pain after laminaria insertion suggests patient would benefit from more effective methods of pain control at laminaria insertion and during the post-laminaria interval. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Misoprostol use under routine conditions for termination of pregnancies with intrauterine fetal death

    OpenAIRE

    Nascimento, Maria Isabel do; Cunha, Alfredo de Almeida; Oliveira, Sandra Regina dos Santos Muri; Nunes, Glaucimara Gonzaga; Alvarez, Felipe Silva; Villas Bôas, Eduardo Loyola

    2013-01-01

    OBJECTIVE: To analyze the misoprostol use in pregnancies with intrauterine fetal death (IUFD), considering mode of delivery and induction-delivery interval. METHODS: Descriptive study including 171 pregnant women with IUFD, in the second or third trimester, submitted to labor induction with vaginal misoprostol and/or induction/augmentation with intravenous oxytocin, from 2005 to 2008, at a teaching-hospital of the Brazilian Unified Health System (Sistema Único de Saúde -SUS). RESULTS: Misopro...

  9. Pelvic endometriosis with peritoneal fluid reduces pregnancy rates in women undergoing intrauterine insemination

    OpenAIRE

    Wu, Hong-Ming; Tzeng, Chii-Ruey; Chen, Chi-Hung; Chen, Pi-Hua

    2013-01-01

    Objective: This study investigated the occurrence of peritoneal fluid in women undergoing intrauterine insemination (IUI) and its correlation with the stage of pelvic endometriosis and its influence on pregnancy outcomes. Materials and Methods: A retrospective case–control design was used to recruit 272 infertile women with pelvic endometriosis. The treatment protocol consisted of controlled ovarian hyperstimulation with downregulation and gonadotropin for IUI treatment following ultrasoun...

  10. Complications and continuation of intrauterine device use among commercially insured teenagers.

    Science.gov (United States)

    Berenson, Abbey B; Tan, Alai; Hirth, Jacqueline M; Wilkinson, Gregg S

    2013-05-01

    Many U.S. health care providers remain reluctant to prescribe intrauterine devices (IUDs) to teenagers as a result of concerns about serious complications. This study examined whether 15-19-year-old IUD users were more likely to experience complications, failure, or early discontinuation than adult users aged 20-24 years and 25-44 years and whether there were differences in these outcomes between users of levonorgestrel-releasing intrauterine systems and copper IUDs. A retrospective cohort study was conducted using health insurance claims obtained from a private insurance company of 90,489 women who had an IUD inserted between 2002 and 2009. Logistic regression models were used to estimate the odds of experiencing complications, method failure, or early discontinuation within 12 months of insertion by age group and type of IUD inserted. Serious complications, including ectopic pregnancy and pelvic inflammatory disease, occurred in less than 1% of patients regardless of age or IUD type. Women aged 15-19 years were more likely than those aged 25-44 years to have a claim for dysmenorrhea (odds ratio [OR] 1.4, confidence interval [CI] 1.1-1.6), amenorrhea (OR 1.3, CI 1.1-1.5), or normal pregnancy (OR 1.4, CI 1.1-1.8). Overall, early discontinuation did not differ between teenagers and women aged 25-44 years (13% compared with 11%, P>.05). However, use of the levonorgestrel-releasing intrauterine system was associated with fewer complications and less early discontinuation than the copper IUD in all age groups. The IUD is as appropriate for teenagers to use as it is for older women, with serious complications occurring infrequently in all groups. The levonorgestrel-releasing intrauterine system may be a better choice than the copper IUD as a result of lower odds of complications, discontinuation, and failure. II.

  11. Laparoscopic Removal of An Ectopic Intrauterine Device From The Anterior Abdominal Wall

    Directory of Open Access Journals (Sweden)

    Yaprak Engin Üstün

    2006-12-01

    Full Text Available The intrauterine devices (IUDs have been used widely by women of childbearing years. In this report, we presented a case of a 25-year-old gravida 4, parity 3 woman with an abdominal wall penetration by an IUD. She had an IUD (TCu-380A inserted immediately after dilatation & curettage. The IUD was removed laparoscopically.

  12. Ureteric erosion and obstruction: A rare but dreaded complication of intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Vinod Priyadarshi

    2017-01-01

    Full Text Available Though intrauterine contraceptive device (IUCD is a safe and most frequently used long-term contraceptive method, it has some complications. Uterine perforation and intra-abdominal migration have been reported often, but a retroperitoneal migration is exceptional. Here, we are reporting an IUCD which perforated the uterus and migrated to the retroperitoneum; impinging into and obstructing left ureter causing severe hydroureteronephrosis due to the development of the left lower ureteric stricture.

  13. Translocation of an Intrauterine Contraceptive Device: Incidental Finding in the Rectosigmoid Colon

    Directory of Open Access Journals (Sweden)

    R. Vilallonga

    2010-01-01

    Full Text Available The presence of an intrauterine device (IUD within the colon is rare. Complications have been reported with IUDs among which uterine perforation. Translocation of IUDs to the uterine cavity, to the bladder and also through the wall of the bowel, and sigmoid colon has been reported. We believe there may be a case that surgeons should know the result of despite being a priori gynaecological complication. This paper reports on a case of colon perforation by an IUD.

  14. Intravesical migration of an intrauterine device detected in a pregnant woman

    Science.gov (United States)

    Tosun, Migraci; Celik, Handan; Yavuz, Erhan; Çetinkaya, Mehmet B.

    2010-01-01

    The intrauterine device (IUD) is common method of contraception among women because of its low cost and high efficacy. Perforations are possible; most perforations occur at the time of insertion, yet the complication can occur with a previously inserted IUD. Perforation of the bladder by an IUD is extremely rare. In this report, we present a case in which the IUD perforated the uterus and migrated to the bladder. At the time of the diagnosis, the patient was 8 weeks pregnant. PMID:20944794

  15. Intrauterine synechiae after myomectomy; laparotomy versus laparoscopy: Non-randomized interventional trial

    Science.gov (United States)

    Asgari, Zahra; Hafizi, Leili; Hosseini, Rayhaneh; Javaheri, Atiyeh; Rastad, Hathis

    2015-01-01

    Background: Leiomyomata is the most frequent gynecological neoplasm. One of the major complications of myomectomy is intrauterine adhesion (synechiae). Objective: To evaluate and compare the rate and severity of synechiae formation after myomectomy by laparotomy and laparoscopy. Materials and Methods: In this non-randomized interventional trial, hysteroscopy was performed in all married fertile women who had undergone myomectomy (type 3-6 interamural and subserosal fibroids) via laparotomy and laparoscopy in Tehran’s Arash Hospital from 2010 to 2013. Three months after the operation, the occurrence rate and severity of intrauterine synechiae, and its relationship with type, number and location of myomas were investigated and compared in both groups. Results: Forty patients (19 laparoscopy and 21 laparotomy cases) were studied. Both groups were similar regarding the size, type (subserosal or intramural), number and location of myoma. The occurrence rate of synechiae in the laparoscopy and laparotomy group was 21% and 19%, respectively; showing no significant difference (p=0.99). Among all patients, no significant relationship was found between the endometrial opening (p=0.92), location (p=0.14) and type of myoma (p=0.08) with the occurrence rate of synechiae. However, a significant relationship was observed between myoma’s size (p=0.01) and the location of the largest myoma with the occurrence of synechiae (p=0.02). Conclusion: With favorable suturing methods, the outcome of intrauterine synechiae formation after myomectomy, either performed by laparotomy or laparoscopy, is similar. In all cases of myomectomy in reproductive-aged women, postoperative hysteroscopy is highly recommended to better screen intrauterine synechiae. PMID:26000007

  16. Head trauma in China.

    Science.gov (United States)

    Jiang, Ji-Yao

    2013-11-01

    The Chinese Head Trauma Data Bank (CHTDB) has been established, which includes 7,145 hospitalised cases with acute head trauma patients in 47 hospitals. We explored factors that might affect the outcome of acute traumatic brain injury. There was no statistical difference in the mortality rate between male (7.5%) and female (7.2%) patients (P>0.05). The mortality rate in children (65 years) was 7.3%, 7.2% and 9.0%, respectively (P>0.05). The mortality rate of patients with mild (2.7%), moderate (5.0%) and severe (21.8%) head trauma was significantly different (P40 mm Hg was 6.3%, 21.4% and 93.1%, respectively (Phead trauma data bank in China, has one of the largest numbers of cases of any head trauma data bank in the world. Our major findings on mortality may be helpful to neurosurgeons for predicting the outcome of acute head trauma patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. [Specificity and incidence of erythrocyte antibodies in pregnant patients with intrauterine transfusions for fetal erythroblastosis].

    Science.gov (United States)

    Hoch, H; Giers, G; Bald, R; Hanfland, P

    1992-01-01

    The specificity and frequency of irregular erythrocyte alloantibodies in serum obtained from 85 pregnant women managed by a total of 480 intrauterine transfusions for treatment of fetal erythroblastosis was examined over a 4-year observation period. 138 alloantibodies reactive in the indirect antiglobulin test were detected. Their specificities were widespread. The frequency of non-anti-D alloantibodies primarily responsible for fetal immunohemolysis confirmed by elution from fetal red cells increased to 8% compared with studies performed in the 70s. 16 (19%) patients developed additional alloantibodies after onset of intrauterine transfusion therapy. Regarding the fact of the high incidence of secondarily induced alloantibodies, the high prevalence of antibody mixtures and the occurrence of rare alloantibodies against blood group antigens with weak immunogenic potency, we concluded that many of the patients were 'high responders'. Therefore the role of fetomaternal transplacental hemorrhage induced by invasive intrauterine examination methods and transfusions is discussed here. It obviously has to be considered as the main cause of the immunohematologic complications.

  18. Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

    Energy Technology Data Exchange (ETDEWEB)

    Gemert, Martin J C van; Wijngaard, Jeroen P H M van den [Laser Centre and Department of Obstetrics, Laser Center, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Lopriore, Enrico [Division of Neonatology, Department of Pediatrics, Leiden University Medical Centre, Leiden (Netherlands); Pasman, Suzanne A; Vandenbussche, Frank P H A [Division of Fetal Medicine, Department of Obstetrics, Leiden University Medical Centre, Leiden (Netherlands)], E-mail: m.j.vangemert@amc.uva.nl

    2008-04-07

    Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others. (note)

  19. Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

    International Nuclear Information System (INIS)

    Gemert, Martin J C van; Wijngaard, Jeroen P H M van den; Lopriore, Enrico; Pasman, Suzanne A; Vandenbussche, Frank P H A

    2008-01-01

    Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others. (note)

  20. NOTE: Arterio-venous flow between monochorionic twins determined during intra-uterine transfusion

    Science.gov (United States)

    van Gemert, Martin J. C.; van den Wijngaard, Jeroen P. H. M.; Lopriore, Enrico; Pasman, Suzanne A.; Vandenbussche, Frank P. H. A.

    2008-04-01

    Twin-twin transfusion syndrome (TTTS) is a severe complication of monozygotic (identical) twin fetuses sharing one single (monochorionic) placenta. TTTS is caused by a net inter-twin transfusion of blood through placental anastomoses, from one twin (the donor) to the other (the recipient), which link the two feto-placental circulations. Currently, the only reliable method to measure the net inter-twin transfusion clinically is when incomplete laser therapy of TTTS occurs and one of the twins becomes anemic and requires an intra-uterine transfusion of adult red blood cells. Then, differences between adult hemoglobin concentrations measured during the transfusion and at birth relate not only to the net inter-twin transfusion but also to the finite lifetime of the adult red blood cells. We have analyzed this situation, derived the differential equations of adult hemoglobin in the donor and recipient twins, given the solutions and given expressions relating the net inter-twin flow with clinically measured parameters. We have included single and multiple intra-uterine transfusions. In conclusion, because incomplete laser therapy occurs frequently, and some cases require an intra-uterine transfusion, this method may allow collecting a wealth of net inter-twin flow data from clinicians involved in laser therapy of TTTS. To aid to the widespread use of this method, we have presented the equations as clearly as possible in tables for easy use by others.

  1. FFPRHC Guidance (January 2004). The copper intrauterine device as long-term contraception.

    Science.gov (United States)

    Penney, Gillian; Brechin, Susan; de Souza, Alison; Bankowska, Urszula; Belfield, Toni; Gormley, Maggie; Olliver, Mary; Hampton, Naomi; Howlett-Shipley, Ruth; Hughes, Sarah; Mack, Noel; O'Brien, Paul; Rowlands, Sam; Trewinnard, Karen

    2004-01-01

    This Guidance provides information for clinicians providing women with copper-bearing intrauterine devices as long-term contraception. A key to the grades of recommendations, based on levels of evidence, is given at the end of this document. Details of the methods used by the Clinical Effectiveness Unit (CEU) in developing this Guidance and evidence tables summarising the research basis of the recommendations are available on the Faculty website (www.ffprhc.org.uk). Abbreviations (in alphabetical order) used include: acquired immune deficiency syndrome (AIDS); actinomyces-like organisms (ALOs); automated external defibrillator (AED); blood pressure (BP); British National Formulary (BNF); confidence interval (CI); copper-bearing intrauterine contraceptive device (IUD); emergency contraception (EC); Faculty Aid to Continuing Professional Development Topic (FACT); levonorgestrel-releasing intrauterine system (IUS); human immunodeficiency virus (HIV); Medicines and Healthcare products Regulatory Agency (MHRA); non-steroidal antiinflammatory drugs (NSAIDs); odds ratio (OR); pelvic inflammatory disease (PID); relative risk (RR); Royal College of Obstetricians and Gynaecologists (RCOG); Scottish Intercollegiate Guidelines Network (SIGN); sexually transmitted infection (STI); termination of pregnancy (TOP); World Health Organization (WHO); WHO Medical Eligibility Criteria (WHOMEC); WHO Selected Practice Recommendations (WHOSPR).

  2. Stillbirth and intrauterine fetal death: factors affecting determination of cause of death at autopsy.

    Science.gov (United States)

    Man, J; Hutchinson, J C; Heazell, A E; Ashworth, M; Levine, S; Sebire, N J

    2016-11-01

    There have been several attempts to classify cause of death (CoD) in stillbirth; however, all such systems are subjective, allowing for observer bias and making comparisons between systems challenging. This study aimed to examine factors relating to determination of CoD using a large dataset from two specialist centers in which observer bias had been reduced by classifying findings objectively and assigning CoD based on predetermined criteria. Detailed autopsy reports from intrauterine deaths in the second and third trimesters during 2005-2013 were reviewed and findings entered into a specially designed database, in which CoD was assigned using predefined objective criteria. Data regarding CoD categories and factors affecting determination of CoD were examined. There were 1064 intrauterine deaths, including 246 early intrauterine fetal deaths (IUFD) (autopsy examination. The rate of unexplained death varies from around 30% to 60% depending on interpretation of the significance of features. CoD determination is dependent on both the classification system used and subjective interpretation, such that variation in the proportion of 'unexplained' cases is based largely on speculation regarding mechanisms of death. Novel methods to determine objectively the mechanism of death at postmortem examination are required. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  3. Sigmoid colon translocation of an intrauterine device misdiagnosed as a colonic polyp: A case report.

    Science.gov (United States)

    Zhou, Xin-Xin; Yu, Mo-Sang; Gu, Meng-Li; Zhong, Wei-Xiang; Wu, Hong-Ru; Ji, Feng; Pan, Hang-Hai

    2018-02-01

    Intrauterine contraceptive devices (IUDs) are recommended as a means of contraception. Translocation of IUD is a rare and serious complication. Colonic inflammatory mass caused by translocated IUD initially misdiagnosed as a colonic polyp is extremely rare and has not been reported yet. This report presents a case of sigmoid colon translocation of intrauterine device on a 37-year-old female patient. Colonoscopy was performed due to her complain of repeated blood in stools and subsequently the patient was misdiagnosed as a sigmoid colon polyp. Nonetheless, the "polyp" was not able to be removed endoscopically. Sigmoid colon translocation of an intrauterine device. To further clarify the diagnosis, computed tomography (CT) scan was performed and the "polyp" was confirmed to be caused by a translocated IUD. The translocated IUD was removed easily by surgery, and the patient recovered soon after the operation. The present case indicates that an annual gynaecologic examination is necessary to determine the position of the IUD, and a CT examination may help confirm an ectopic IUD.

  4. Is intrauterine exchange transfusion a safe procedure for management of fetal anaemia?

    Science.gov (United States)

    Garabedian, C; Philippe, M; Vaast, P; Wibaut, B; Salleron, J; Delsalle, A; Rakza, T; Subtil, D; Houfflin-Debarge, V

    2014-08-01

    To study modalities and complications of intrauterine exchange transfusion (IUET) for the management of severe fetal anaemia. Retrospective study of all IUET procedures performed between January 1999 and January 2012 at a regional centre. Characteristics of each procedure were studied to identify risk factors for complications. Survival rates according to the different aetiologies of anaemia were evaluated. In total, 225 IUET procedures were performed in 96 fetuses. Major indications were feto-maternal erythrocyte alloimmunization (n=80/96, 83.3%) and parvovirus B19 infection (n=13/96, 13.5%). Twenty-six percent of the fetuses (25/96) had hydrops fetalis before the first IUET. Intrauterine fetal death occurred after 2.7% (6/225) of procedures, premature rupture of the membranes occurred after 0.9% (2/225) of procedures, and emergency caesarean section was required after 3.6% (8/225) of procedures. Fetal bradycardia [odds ratio (OR) 37, 95% confidence interval (CI) 8.3-170; prate in the study cohort was 87.5% (84/96): 90% (72/80) in the alloimmunization group and 76.9% (10/13) in the parvovirus-infected group (NS). IUET has a higher complication rate than simple intrauterine transfusion, and should be performed by well-trained specialists. Copyright © 2014. Published by Elsevier Ireland Ltd.

  5. [Customized and non-customized French intrauterine growth curves. I - Methodology].

    Science.gov (United States)

    Ego, A; Prunet, C; Lebreton, E; Blondel, B; Kaminski, M; Goffinet, F; Zeitlin, J

    2016-02-01

    We developed intrauterine growth references, called EPOPé curves, in line with recommendations for screening of intra-uterine growth restriction issued in 2013 by the French College of Obstetricians and Gynecologists. Using the French Perinatal Survey (FPS) 2010, we adapted the methodology developed by Gardosi (1) to model intrauterine growth and its distribution and (2) to adjust for physiological fetal and maternal factors influencing fetal weight. Based on this model, 3 reference curves (unadjusted, adjusted for fetal sex, and adjusted for fetal sex, and maternal height, weight and parity) were proposed. We applied these models to births in the 2010 FPS and the French hospital discharge database (PMSI) in 2011-2012. Among singleton live births in the FPS and the PMSI, the model adjusted for fetal sex identified 3.2 and 3.3% of births below the 3rd centile respectively, and 10.0 and 10.2% below the 10th. In model adjusted for maternal factors, 4.0% of births from the FPS 2010 were reclassified, but population rates remained at 3.0 and 10.0%. This growth model is appropriate for French births, and allows for the implementation of a homogeneous definition of small for gestational age infants during pregnancy and at birth. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Adeola Fowotade

    2013-12-01

    Full Text Available Infection with genital herpes simplex virus (HSV remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.

  7. Genomic biomarkers of prenatal intrauterine inflammation in umbilical cord tissue predict later life neurological outcomes.

    Directory of Open Access Journals (Sweden)

    Sloane K Tilley

    Full Text Available Preterm birth is a major risk factor for neurodevelopmental delays and disorders. This study aimed to identify genomic biomarkers of intrauterine inflammation in umbilical cord tissue in preterm neonates that predict cognitive impairment at 10 years of age.Genome-wide messenger RNA (mRNA levels from umbilical cord tissue were obtained from 43 neonates born before 28 weeks of gestation. Genes that were differentially expressed across four indicators of intrauterine inflammation were identified and their functions examined. Exact logistic regression was used to test whether expression levels in umbilical cord tissue predicted neurocognitive function at 10 years of age.Placental indicators of inflammation were associated with changes in the mRNA expression of 445 genes in umbilical cord tissue. Transcripts with decreased expression showed significant enrichment for biological signaling processes related to neuronal development and growth. The altered expression of six genes was found to predict neurocognitive impairment when children were 10 years old These genes include two that encode for proteins involved in neuronal development.Prenatal intrauterine inflammation is associated with altered gene expression in umbilical cord tissue. A set of six of the differentially expressed genes predict cognitive impairment later in life, suggesting that the fetal environment is associated with significant adverse effects on neurodevelopment that persist into later childhood.

  8. Changes in GH/IGF-1 axis in intrauterine growth retardation: consequences of fetal programming?

    Science.gov (United States)

    Setia, S; Sridhar, M G

    2009-11-01

    Fetal growth is a complex process that depends on the genotype and epigenotype of the fetus, maternal nutrition, the availability of nutrients and oxygen to the fetus, intrauterine insults, and a variety of growth factors and proteins of maternal and fetal/placental origin. In the fetus, growth hormone (GH) plays little or no role in regulating fetal growth, and insulin-like growth factors (IGFs) control growth directly independent of fetal GH secretion. Placental growth hormone (PGH) is the prime regulator of maternal serum IGF-1 during pregnancy. Total as well as free PGH and IGFs are significantly lower in pregnancies with intrauterine growth retardation (IUGR). The GH/IGF axis is significantly affected by intrauterine growth retardation and some of these alterations may lead to permanent pathological programming of the IGF axis. Alterations in the IGF axis may play a role in the future occurrence of insulin resistance and hypertension. In this review we focus on the regulation of fetal growth and the role of fetal programming in the late consequences of a poor fetal environment reflected in IUGR.

  9. Head first Ajax

    CERN Document Server

    Riordan, Rebecca M

    2008-01-01

    Ajax is no longer an experimental approach to website development, but the key to building browser-based applications that form the cornerstone of Web 2.0. Head First Ajax gives you an up-to-date perspective that lets you see exactly what you can do -- and has been done -- with Ajax. With it, you get a highly practical, in-depth, and mature view of what is now a mature development approach. Using the unique and highly effective visual format that has turned Head First titles into runaway bestsellers, this book offers a big picture overview to introduce Ajax, and then explores the use of ind

  10. Head First Statistics

    CERN Document Server

    Griffiths, Dawn

    2009-01-01

    Wouldn't it be great if there were a statistics book that made histograms, probability distributions, and chi square analysis more enjoyable than going to the dentist? Head First Statistics brings this typically dry subject to life, teaching you everything you want and need to know about statistics through engaging, interactive, and thought-provoking material, full of puzzles, stories, quizzes, visual aids, and real-world examples. Whether you're a student, a professional, or just curious about statistical analysis, Head First's brain-friendly formula helps you get a firm grasp of statistics

  11. Effect of Different Intrauterine Oxytetracycline Treatment on Reproductive Performance of Dairy Cows with Clinical Endometritis and Determination of Oxytetracycline Residues in Milk

    OpenAIRE

    MAKKI, Meysam; GHEISARI, Hamid; AHMADI, Mohammad

    2016-01-01

    Main objective of this study was to determine whether intrauterine infusion of oxytetracycline (OTC) is an appropriate method for the treatment of postpartum endometritis in dairy cows or not. To this end, 280 lactating Holstein cows with clinical signs of endometritis were randomly assigned into three treatment groups and 186 cows were sampled for cytology experiment. In group 1 (n=73) cows were treated with intrauterine infusion of 5 g/cow 10% OTC. In group 2 (n=44), before intrauterine OTC...

  12. Reactor pressure vessel vented head

    Science.gov (United States)

    Sawabe, James K.

    1994-01-11

    A head for closing a nuclear reactor pressure vessel shell includes an arcuate dome having an integral head flange which includes a mating surface for sealingly mating with the shell upon assembly therewith. The head flange includes an internal passage extending therethrough with a first port being disposed on the head mating surface. A vent line includes a proximal end disposed in flow communication with the head internal passage, and a distal end disposed in flow communication with the inside of the dome for channeling a fluid therethrough. The vent line is fixedly joined to the dome and is carried therewith when the head is assembled to and disassembled from the shell.

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head ...

  14. Silva as the Head

    DEFF Research Database (Denmark)

    Svabo, Connie

    2015-01-01

    The head of the performance design programme is substituted by a sister's academy delegate. this performance situation formed part of a week of semesterstart where the students and professors visited Sister's Academy, Malmø. I participated in the Sister's Academy as visiting researcher and here...

  15. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. It also helps your doctor to evaluate your face, sinuses, and skull or to plan radiation therapy for brain cancer. In emergency cases, it can ...

  16. Overview of Head Injuries

    Science.gov (United States)

    ... falls, motor vehicle crashes, assaults, and mishaps during sports and recreational activities. People with minor head injuries may have a headache ... feel part of the body Inability to recognize people or the ... vision, or blind spots) Drainage of clear fluid (cerebrospinal fluid) from ...

  17. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... on head injuries, stroke , brain tumors and other brain diseases than regular radiographs (x-rays). top of page ... to obtain a tissue sample ( biopsy ) from the brain. assess aneurysms or ... or any disorder of the heart, kidneys or thyroid gland , or ...

  18. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography ( ...

  19. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... head injuries, stroke , brain tumors and other brain diseases than regular radiographs (x-rays). top of page ...

  20. Head Lice: Information for Parents

    Science.gov (United States)

    ... Tropical Diseases Laboratory Diagnostic Assistance [DPDx] Parasites Home Head Lice Information for Parents Language: English Español (Spanish) ... Tweet Share Compartir You should examine your child's head, especially behind the ears and at the nape ...

  1. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... are the limitations of MRI of the Head? What is MRI of the Head? Magnetic resonance imaging ( ... brain) in routine clinical practice. top of page What are some common uses of the procedure? MR ...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ...

  3. Childhood Head and Neck Irradiation

    Science.gov (United States)

    ... Thyroid Association ® www.thyroid.org Childhood Head & Neck Irradiation What is the thyroid gland? The thyroid gland ... Thyroid Association ® www.thyroid.org Childhood Head & Neck Irradiation Thyroid nodules (see Thyroid Nodule brochure) • Thyroid nodules ...

  4. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful magnetic field, radio waves and a computer to produce ...

  5. Magnetic Resonance Imaging (MRI) -- Head

    Medline Plus

    Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association ... MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging ( ...

  6. Comparison of two cohorts of women who expulsed either a copper-intrauterine device or a levonorgestrel-releasing intrauterine system.

    Science.gov (United States)

    Simonatto, Paula; Bahamondes, Maria Valeria; Fernandes, Arlete; Silveira, Carolina; Bahamondes, Luis

    2016-05-01

    To assess if there is a difference in the characteristics of the women who expelled a copper-intrauterine device (TCu-IUD) or the levonorgestrel-releasing intrauterine system (LNG-IUS) and the frequency of expulsions over different periods of observation. We retrospectively analyzed 19 697 medical charts of women consulting between January 1980 and December 2013 who requested a TCu-IUD or a LNG-IUS. The medical records of 17 644 Cu-IUD and 2053 LNG-IUS users returning to the clinic for a follow-up visit after insertion of an IUC were reviewed. Of these, 1532 Cu-IUD and 254 LNG-IUS parous users were found to have expelled the IUC for a first time. The mean age at insertion (± standard deviation) was 26.3 ± 6.6 years (range 16-49) for Cu-IUD users and 31.7 ± 7.6 years (range 18-48) for LNG-IUS users (P < 0.001). A total of 263 (13.4%) and 12 (4.3%) of the Cu-IUD and the LNG-IUS users were ≤19 years old, and 49.1% and 54.1% of the expulsions among the Cu-IUD and LNG-IUS users, respectively, were reported in the first six months after placement. A regression model showed that the variables significantly associated with an expulsion of either a Cu-IUD or LNG-IUS were age < 25 years, less than two deliveries and using a Cu-IUD. Our findings showed that the characteristics associated with IUC expulsion were age under 25 years, having had less than two deliveries and being users of Cu-IUD. © 2016 Japan Society of Obstetrics and Gynecology.

  7. Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use.

    Science.gov (United States)

    Modesto, Waleska; de Nazaré Silva dos Santos, Priscila; Correia, Vinicius Machado; Borges, Luiza; Bahamondes, Luis

    2015-02-01

    Data on record regarding weight variation in depot-medroxyprogesterone acetate (DMPA) and levonorgestrel-releasing intrauterine system (LNG-IUS) users are controversial. To date, no studies have yet evaluated weight variation in DMPA and LNG-IUS users in up to ten years of use compared to non-hormonal contraceptive users. A retrospective study analysed weight variations in 2138 women using uninterruptedly DMPA (150 mg intramuscularly, three-monthly; n = 714), the LNG-IUS (n = 701) or a copper-intrauterine device (Cu-IUD; n = 723). At the end of the first year of use, there was a mean weight increase of 1.3 kg, 0.7 kg and 0.2 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively, compared to weight at baseline (p < 0.0001). After ten years of use, the mean weight had risen by 6.6 kg, 4.0 and 4.9 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively. DMPA-users had gained more weight than LNG-IUS- (p = 0.0197) and than Cu-IUD users (p = 0.0294), with the latter two groups not differing significantly from each other in this respect (p = 0.5532). Users of hormonal and non-hormonal contraceptive methods gained a significant amount of weight over the years. DMPA users gained more weight over the treatment period of up to ten years than women fitted with either a LNG-IUS or a Cu-IUD.

  8. Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants.

    Science.gov (United States)

    Taneepanichskul, Surasak; Reinprayoon, Damrong; Thaithumyanon, Pimolratn; Praisuwanna, Pramote; Tosukhowong, Piyaratana; Dieben, Thom

    2006-04-01

    The study objectives were to compare the effects of an etonogestrel-releasing implant (Implanon) and a nonmedicated intrauterine device (IUD) on parameters of lactation in breast-feeding women and on the growth of their breast-fed infants over a 3-year period. Healthy lactating women (28-56 days postpartum) chose either the implant (n=42) or the IUD (n=38). Infant growth during a 3-year follow-up period is reported here. Total duration of breast-feeding coinciding with the mothers' treatment was 421.0 and 423.4 days in the Implanon and IUD groups, respectively. There were no differences between the infant groups in terms of body length, biparietal head circumference and body weight. No abnormalities were reported in psychomotor development or during physical examination. No treatment-related side effects were observed in either group. In conclusion, there were no differences in the growth of breast-fed infants of women treated with Implanon or a nonmedicated IUD. Implanon, therefore, appears to be a safe contraceptive option for breast-feeding women and their infants.

  9. A large bladder stone caused by the intravesical migration of an intrauterine contraceptive device: a case report.

    Science.gov (United States)

    De Silva, W S L; Kodithuwakku, K A S U A; Aponsu, G U E; Rathnayake, R M M; Rajasegaram, E

    2017-10-22

    A wide variety of complications due to the extrauterine migration of intrauterine contraceptive devices have been reported in the literature. Here we describe the case of a large bladder stone formed around a migrated Copper T380A device that was neglected and detected 15 years after insertion. A 48-year-old Sri Lankan woman underwent a workup for lower urinary tract symptoms and recurrent urinary tract infections over the previous 6 months. The radiographs showed a large bladder stone with an imprint of an intrauterine contraceptive device in the center of it. The device had been inserted 15 years previously. Two years after the insertion, it was considered to be missing, but our patient did not comply with the recommended follow-up. She had been completely asymptomatic until she developed lower urinary tract symptoms. After confirming the location of the stone via ultrasonography, a vesicolithotomy was performed, revealing a stone with three limbs corresponding to the shape of the Copper T380A device. The device and the threads were fully covered with the stone material. Our patient was asymptomatic following the surgery. A migrated intrauterine contraceptive device can act as the nidus for the formation of a secondary bladder stone. The detailed imprint of the device inside the stone and the laminated appearance of the stone material were characteristic of a secondary bladder stone formed around an intrauterine contraceptive device. Radiography and ultrasonography are adequate for the diagnosis of intravesical migration of intrauterine contraceptive devices.

  10. Fetal Programming of Body Composition, Obesity, and Metabolic Function: The Role of Intrauterine Stress and Stress Biology

    Directory of Open Access Journals (Sweden)

    Sonja Entringer

    2012-01-01

    Full Text Available Epidemiological, clinical, physiological, cellular, and molecular evidence suggests that the origins of obesity and metabolic dysfunction can be traced back to intrauterine life and supports an important role for maternal nutrition prior to and during gestation in fetal programming. The elucidation of underlying mechanisms is an area of interest and intense investigation. In this perspectives paper we propose that in addition to maternal nutrition-related processes it may be important to concurrently consider the potential role of intrauterine stress and stress biology. We frame our arguments in the larger context of an evolutionary-developmental perspective that supports roles for both nutrition and stress as key environmental conditions driving natural selection and developmental plasticity. We suggest that intrauterine stress exposure may interact with the nutritional milieu, and that stress biology may represent an underlying mechanism mediating the effects of diverse intrauterine perturbations, including but not limited to maternal nutritional insults (undernutrition and overnutrition, on brain and peripheral targets of programming of body composition, energy balance homeostasis, and metabolic function. We discuss putative maternal-placental-fetal endocrine and immune/inflammatory candidate mechanisms that may underlie the long-term effects of intrauterine stress. We conclude with a commentary of the implications for future research and clinical practice.

  11. Intrauterine Growth Restriction and the Fetal Programming of the Hedonic Response to Sweet Taste in Newborn Infants

    Directory of Open Access Journals (Sweden)

    Caroline Ayres

    2012-01-01

    Full Text Available Intrauterine growth restriction is associated with increased risk for adult metabolic syndrome and cardiovascular disease, which seems to be related to altered food preferences in these individuals later in life. In this study, we sought to understand whether intrauterine growth leads to fetal programming of the hedonic responses to sweet. Sixteen 1-day-old preterm infants received 24% sucrose solution or water and the taste reactivity was filmed and analyzed. Spearman correlation demonstrated a positive correlation between fetal growth and the hedonic response to the sweet solution in the first 15 seconds after the offer (r=0.864, P=0.001, without correlation when the solution given is water (r=0.314, P=0.455. In fact, the more intense the intrauterine growth restriction, the lower the frequency of the hedonic response observed. IUGR is strongly correlated with the hedonic response to a sweet solution in the first day of life in preterm infants. This is the first evidence in humans to demonstrate that the hedonic response to sweet taste is programmed very early during the fetal life by the degree of intrauterine growth. The altered hedonic response at birth and subsequent differential food preference may contribute to the increased risk of obesity and related disorders in adulthood in intrauterine growth-restricted individuals.

  12. Clinical value of detection of HPL-expressing intermediate trophoblasts in abortion or curettage-obtained specimens for diagnosis of intrauterine or ectopic pregnancies

    International Nuclear Information System (INIS)

    He Xiaomei; Wang Yuping; Wang Lisha; Yang Jingxiu; Gao Xueyan

    2005-01-01

    Objective: To investigate the value of detection of HPL-expressing intermediate trophoblasts in endometrial specimens for diagnosis of intrauterine and ectopic pregnancies. Methods: The examined specimens included: (1) Group I, 35 specimens with suspected intermediate trophoblast in decidua (2) Group II, 30 specimens with decidua-like plump endometrial stroma cells and/ or A-S phenomena in glandular epithelium (3) 30 specimens from proven intrauterine pregnancies serving as controls. Histochemistry (SP method) was used for HPL detection in all these specimens. Results: In the 30 proven intrauterine pregnancies, decidua and villa were present in all the specimens. Only 24 of the 30 were found to be HPL(+) with 6 HPL negatives (20%). In Group I , 28 of the 35 specimens were found to be HPL(+) and all of 28 were from intrauterine pregnancies: Of the 7 HPL negative cases, 5 were later confirmed as with ectopic pregnancy, the remaining 2 were with intrauterine pregnancy. In Group II, 22 of 30 specimens were HPL(+) and all were from intrauterine pregnancy. Of the 8 HPL negative cases, 6 were later confirmed as with ectopic pregnancy and 2 were with intrauterine pregnancy. Combining the data from Group I and II, we could see that in the total 15 HPL negative cases, 11 were with ectopic pregnancy (11/15=73.3%) and 4 were with intrauterine pregnancy (4/15=26.7%). Conclusion: In specimens of intrauterine contents, demonstration of HPL (+) cells could be regarded as confirmative evidence of intrauterine pregnancy. However, the reverse did not hold true. Many of the HPL negative specimens were from intrauterine pregnancies (in this study 4/15 or 26.7%). Therefore, in HPL negative cases, there was a high possibility of ectopic pregnancy but further examinations were required to ascertain the diagnosis. (authors)

  13. Where are we heading

    International Nuclear Information System (INIS)

    Noto, L.A.

    1996-01-01

    The present paper deals with different aspects connected to the global petroleum industry by discussing the way of heading. The aspects cover themes like new frontiers, new relationships, sanctions, global climate change, new alliances and new technology. New frontiers and relationships concern domestic policy affecting the industry, and sanctions are discussed in connection with trade. The author discusses the industry's participation in the global environmental policy and new alliances to provide greater opportunity for developing new technology

  14. Where are we heading

    Energy Technology Data Exchange (ETDEWEB)

    Noto, L.A. [Mobil Corporation, (United States)

    1996-12-31

    The present paper deals with different aspects connected to the global petroleum industry by discussing the way of heading. The aspects cover themes like new frontiers, new relationships, sanctions, global climate change, new alliances and new technology. New frontiers and relationships concern domestic policy affecting the industry, and sanctions are discussed in connection with trade. The author discusses the industry`s participation in the global environmental policy and new alliances to provide greater opportunity for developing new technology

  15. Head segmentation in vertebrates

    OpenAIRE

    Kuratani, Shigeru; Schilling, Thomas

    2008-01-01

    Classic theories of vertebrate head segmentation clearly exemplify the idealistic nature of comparative embryology prior to the 20th century. Comparative embryology aimed at recognizing the basic, primary structure that is shared by all vertebrates, either as an archetype or an ancestral developmental pattern. Modern evolutionary developmental (Evo-Devo) studies are also based on comparison, and therefore have a tendency to reduce complex embryonic anatomy into overly simplified patterns. Her...

  16. Features of the cardiovascular system in babies born with different types of intrauterine growth restriction

    Directory of Open Access Journals (Sweden)

    L. V. Kozlova

    2017-01-01

    Full Text Available Based on the data of clinical and anamnestic examination, cardiointervalography, electrocardiography, and Doppler echocardiography, the investigators examined the features of the cardiovascular system in children born by women with compromised somatic and gynecological histories in the outcome of complicated pregnancy. Groups 1 and 2 included 72 and 69 infants with and without fetal growth restriction, respectively. Group 1 comprised Subgroup 1a of 57 infants with asymmetrical intrauterine growth restriction and Subgroup 1b of 15 children with symmetrical one; of them there were 13 and 2 infants with hypoplastic and dysplastic types. Apparently healthy infants born by apparently healthy mothers in the outcome of physiological pregnancies made up Group 3 (n = 25.There is proof that there are significantly important features of autonomic regulation of cardiac activity and morphofunctional characteristics of the heart. The infants with symmetrical intrauterine growth retardation, unlike those with asymmetrical one, were observed to have impaired autonomic regulation of cardiac activity, which was less obvious at birth, deteriorating over time. At birth, the babies had morphological features of the heart and a greater frequency of functioning of fetal communications. Impaired myocardial metabolic processes prevailed within the first month of life and there was a large frequency of changes similar to those in hypertrophic cardiomyopathy by the end of the first half of life.The featuresrevealed in the infants with different types of intrauterine growth restriction require electrocardiographic and ultrasound examinations, a pediatric cardiologist’s consultations at a maternity hospital, and a subsequent personalized follow-up with corrective measures at an outpatient setting. 

  17. Effects of age, parity, and device type on complications and discontinuation of intrauterine devices.

    Science.gov (United States)

    Aoun, Joelle; Dines, Virginia A; Stovall, Dale W; Mete, Mihriye; Nelson, Casey B; Gomez-Lobo, Veronica

    2014-03-01

    To conduct an analysis of intrauterine device (IUD)-related outcomes including expulsion, contraceptive failure, and early discontinuation and to compare these outcomes in regard to age, parity, and IUD type. This was a multicenter retrospective chart review of adolescents and women aged 13-35 years who had an IUD inserted for contraception between June 2008 and June 2011. A total of 2,523 patients' charts were reviewed. Of these, 2,138 patients were included in our analysis. After a mean follow-up of 37±11 months, the overall rates of IUD expulsion and pregnancy were 6% and 1%, respectively, and were not significantly different by age or parity. Intrauterine device discontinuation rates were 19% at 12 months and 41% after a mean follow-up of 37 months. Despite similar rates of IUD discontinuation between age groups at 12 months of use, teenagers and young women aged 13-19 years were more likely to request early discontinuation at the end of the total follow-up period. No significant difference was noted in pelvic inflammatory disease rates (2%) based on age. After adjusting for age and parity, we found that copper IUD users were more likely to experience expulsion and contraception failure compared with levonorgestrel intrauterine system users (hazard ratios 1.62, 95% confidence interval [CI] 1.06-2.50 and hazard ratios 4.89, 95% CI 2.02-11.80, respectively). Similar to adults, IUD use in adolescents and nulliparous women is effective and associated with low rates of serious complications. Health practitioners should therefore consider IUDs for contraception in all females. Teenagers and young women are more likely to request premature discontinuation of their IUDs and may benefit from additional counseling.

  18. Extended use of the intrauterine device: a literature review and recommendations for clinical practice.

    Science.gov (United States)

    Wu, Justine P; Pickle, Sarah

    2014-06-01

    There are multiple advantages to "extended use" of the intrauterine device (IUD) use beyond the manufacturer-approved time period, including prolongation of contraceptive and non-contraceptive benefits. We performed a literature review of studies that have reported pregnancy outcomes associated with extended use of IUDs, including copper IUDs and the levonorgestrel intrauterine system (LNG-IUS). Among parous women who are at least 25 years old at the time of IUD insertion, there is good evidence to support extended use of the following devices: the TCu380A and the TCu220 for 12 years, the Multiload Cu-375 for 10 years, the frameless GyneFix® (330 mm²) for 9 years, the levonorgestrel intrauterine system 52 mg (Mirena®) for 7 years and the Multiload Cu-250 for 4 years. Women who are at least 35 years old at the time of insertion of a TCu380A IUD can continue use until menopause with a negligible risk of pregnancy. We found no data to support use of the LNG-IUS 13.5 mg (Skyla®) beyond 3 years. When counseling about extended IUD use, clinicians should consider patient characteristics and preferences, as well as country- and community-specific factors. Future research is necessary to determine the risk of pregnancy associated with extended use of the copper IUD and the LNG-IUS among nulliparous women and women less than 25 years old at the time of IUD insertion. More data are needed on the potential effect of overweight and obesity on the long-term efficacy of the LNG-IUS. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Fetal programming of blood pressure in a transgenic mouse model of altered intrauterine environment.

    Science.gov (United States)

    Chiossi, Giuseppe; Costantine, Maged M; Tamayo, Esther; Hankins, Gary D V; Saade, George R; Longo, Monica

    2016-12-01

    Nitric oxide is essential in the vascular adaptation to pregnancy, as knockout mice lacking nitric oxide synthase (NOS3) have abnormal utero-placental perfusion, hypertension and growth restriction. We previously showed with ex vivo studies on transgenic animals lacking NOS3 that adverse intrauterine environment alters fetal programming of vascular reactivity in adult offspring. The current research shows that altered vascular reactivity correlates with higher blood pressure in vivo. Our data suggest that higher blood pressure depends on both genetic background (NOS3 deficiency) and uterine environment, becomes more evident with age (> 7 postnatal weeks), activity and stress, is gender specific (preponderant among males), and can be affected by the sleep-awake cycle. In utero or early postnatal life (programming is associated with abnormal blood pressure (BP) profiles in vivo. Mice lacking a functional endothelial nitric oxide synthase (KO, NOS3 -/- ) and wild-type mice (WT, NOS3 +/+ ) were crossbred to generate homozygous NOS3 -/- (KO), maternally derived heterozygous NOS3 +/- (KOM: mother with adverse intrauterine environment from NOS3 deficiency), paternally derived heterozygous NOS3 +/- (KOP: mother with normal in utero milieu) and NOS3 +/+ (WT) litters. BP was measured in vivo at 7, 14 and 21 weeks of age. After univariate analysis, multivariate population-averaged linear regression models were used to identify factors affecting BP. When compared to WT offspring, systolic (SBP), diastolic (DBP) and mean (MAP) BP progressively increased from KOP, to KOM, and peaked among KO (P 7 postnatal weeks), higher locomotor activity, daytime recordings, and recent blood pressure transducer insertion (P < 0.001). Post hoc analysis showed that KOM had higher SBP than KOP (P < 0.05). Our study indicates that adverse intrauterine environment contributes, along with multiple other factors, to account for hypertension; moreover, in utero or early postnatal life may represent

  20. Intrauterine devices and other forms of contraception: thinking outside the pack.

    Science.gov (United States)

    Allen, Caitlin; Kolehmainen, Christine

    2015-05-01

    A variety of contraception options are available in addition to traditional combined oral contraceptive pills. Newer long-acting reversible contraceptive (LARC) methods such as intrauterine devices and subcutaneous implants are preferred because they do not depend on patient compliance. They are highly effective and appropriate for most women. Female and male sterilization are other effective but they are irreversible and require counseling to minimize regret. The contraceptive injection, patch, and ring do not require daily administration, but their typical efficacy rates are lower than LARC methods and similar to those for combined oral contraceptive pills. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Perinatal outcomes in 6,338 singletons born after intrauterine insemination in Denmark, 2007 to 2012

    DEFF Research Database (Denmark)

    Malchau, Sara Sofia; Loft, Anne; Henningsen, Anna-Karina Aaris

    2014-01-01

    OBJECTIVE: To study perinatal outcomes in singletons born after intrauterine insemination (IUI) compared with children born after in vitro fertilization (IVF), intracytoplasmic sperm injection, and spontaneous conception (SC), and to assess predictors of poor outcome in singletons born after IUI......, exploring the effect of ovarian stimulation. DESIGN: National cohort study, 2007-2012. SETTING: Danish national registries. PATIENT(S): Four thousand two hundred twenty-eight singletons born after insemination with partner semen (IUI-H) and 1,881 singletons born after insemination with donor semen...

  2. Umbilical hypercoiling in 2nd- and 3rd-trimester intrauterine fetal death.

    Science.gov (United States)

    Dutman, Annemiek C; Nikkels, Peter G J

    2015-01-01

    Cases of unexplained intrauterine fetal death (IUFD) can be reduced by full placental examination, with or without autopsy. Determination of the umbilical coiling index (UCI) is considered to be a part of full placental examination. Umbilical hypercoiling (UCI above 0.30 coils/cm) is associated with IUFD. In a large retrospective study, we found an incidence of 18% umbilical hypercoiling in IUFD. We explored the association between umbilical hypercoiling and 2nd- and 3rd-trimester IUFD in 77 cases. There was a significant negative correlation between the UCI and gestational age of IUFD (PUCI should be part of the routine placental examination of cases of IUFD.

  3. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    Directory of Open Access Journals (Sweden)

    Bahamondes L

    2015-07-01

    Full Text Available Luis Bahamondes,1 Maria Y Makuch,1 Ilza Monteiro,1 Victor Marin,2 Richard Lynen3 1Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil; 2Department of Obstetrics and Gynecology, Hospital Central, Petróleos Mexicanos, México City, Mexico; 3Bayer HealthCare, Newark, NJ, USA Background: Intrauterine contraceptives (IUCs, including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS, are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs.Methods: A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs.Results: Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0% to 205 (97.6%. Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did

  4. Intrauterine bacterial findings and hormonal profiles in post-partum cows with normal puerperium.

    Science.gov (United States)

    Bekana, M; Jonsson, P; Kindahl, H

    1996-01-01

    The post-partum intrauterine bacterial flora, prostaglandin release, uterine involution and resumption of ovarian activity were studied in 9 Swedish dairy cows during the first 8-week period. Uterine involution was monitored by transrectal examinations of the reproductive tract 3 times weekly. Bacteriological examination was performed from twice weekly uterine biopsies. The main PGF2 alpha metabolite (15-ketodihydro-PGF2 alpha) was monitored from twice daily blood plasma samples, while morning samples were used for progesterone determinations. The cows were assigned to 2 groups: Group I (n = 7) with an uncomplicated puerperal period and Group II (n = 2) with signs of intrauterine infections. A total of 143 biopsies were collected, of which 129 (90.2%) were found to be bacteriologically negative. Thirteen (9.1%) of the remaining 14 biopsies were bacteriologically positive, while one (0.7%) was probably a contamination on a single occasion. The 13 bacteriologically positive biopsies belonged to the Group II cows from which 31 isolates contained 6 different genera of facultative and obligate anaerobic bacteria. Actinomyces pyogenes along with Bacteroides sp. and Fusobacterium necrophorum were found to predominate in a mixed flora. The bacteria were rapidly eliminated and disappeared completely from the uteri towards the end of the third week post-partum. The average number of days required for completion of uterine involution was 21.8 +/- 3.0 for all animals. The plasma levels of the PGF2 alpha metabolite were significantly elevated for the first 12-18, and 18 and 27 days in Group I and Group II, respectively. There was no significant relationship between the duration of PGF2 alpha release and the time required for completion of uterine involution (p > 0.05). Progesterone analysis showed resumption of ovarian activity and subsequent ovulation in 4 of the 9 cows 44-55 days post-partum. Thus, intrauterine infections are not commonly seen in cows with normal calving and

  5. The maternal periodontal disease as a risk factor of intrauterine growth retardation

    OpenAIRE

    Carranza Samanez, Maynor; García Linares, Sixto; Profesor Asociado del D.A. Médico Quirúrgico; Dulanto Vargas, Julissa

    2014-01-01

    This study evaluates the relationship between the intrauterine growth retardation (IUGR) and the maternal periodontal disease (MPD). This case-control study of 120 mothers, 38 cases (mothers of babies with IUGR) and 82 controls (mothers of babies without IUGR) at the “Madre Niño San Bartolomé” Teaching Hospital. The mothers were interrogated and their medical histories were reviewed. Data was recorded, such as: the education level, marital status, smoking, alcohol and drug habits. All the mot...

  6. Evaluation of Intrauterine Structural Pathology by Three-Dimensional Sonohysterography Using An Extended Imaging Method

    Directory of Open Access Journals (Sweden)

    Fatemeh Zafarani

    2013-01-01

    Full Text Available Structural intrauterine abnormalities are an important cause of infertility, recurrentpregnancy loss and bleeding or pain associated with a poor reproductive outcome. Variousdiagnostic methods have been applied to detect these lesions such as hysterosalpingography,hysteroscopy and sonohysterography. More recently, three-dimensionalextended imaging (3DXI provides the ability to obtain sequential sections of acquiredvolume scans in A, B and C planes. Here, we briefly discuss the technique of salineinfusion sonography, followed by a review of sonohysterographic characteristics ofintracavitary pathologies with more focus on some definitions and measurements.

  7. Morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia (experimental research

    Directory of Open Access Journals (Sweden)

    O. V. Kaluzhina

    2015-04-01

    Full Text Available The cardiovascular system in newborns with chronic hypoxia is affected in 40–70%. Aim. To investigate morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia. Methods and results. Aortic wall was investigated with modern morphological methods in 34 laboratory animals in order to identify the morphological features of the fetuses and newborns’ vessel affected by this pathogenic factor. It was established that chronic hypoxia leads to endothelial trophics deterioration, its flattening, dystrophic processes with following cells desquamation, density reduction of smooth muscle cells, thickening of the intima-media. Conclusion. It shows alterative-sclerotic changes in aorta in cases with chronic hypoxia influence.

  8. Chronic vulvovaginal candidiasis in patients using a levonorgestrel-containing intrauterine device.

    Science.gov (United States)

    Nguyen, Yvonne; Fischer, Gayle

    2018-02-01

    Chronic vulvovaginal candidiasis is usually responsive to therapy with oral antifungals. We present a case series of 13 patients with this condition who were also using a levonorgestrel intrauterine system (LNG-IUS). All cases responded to ongoing oral fluconazole therapy while the LNG-IUS was in situ. The LNG-IUS was removed in six patients and of these, two experienced clinical improvement with lower fluconazole dosage requirements and three experienced complete resolution of symptoms. One remains on fluconazole 100 mg daily. © 2016 The Australasian College of Dermatologists.

  9. A three-year evaluation of TCu 380 Ag and multiload Cu 375 intrauterine devices.

    Science.gov (United States)

    Champion, C B; Behlilovic, B; Arosemena, J M; Randic, L; Cole, L P; Wilkens, L R

    1988-12-01

    A randomized, comparative, multicenter clinical trial of TCu 380Ag and Multiload Cu 375 intrauterine devices (IUDs) was conducted. Safety and acceptability were evaluated through three years following insertion in 884 patients. The two IUDs were similar with respect to all event rates. Thirty-six month life table pregnancy rates were 0.6 per 100 TCu 380Ag users and 1.8 per 100 Multiload Cu 375 users. Continuation rates were 67.4 and 61.4 per 100 users of the respective devices at three years after insertion.

  10. Scanning electron microscopy of human uterine epithelium influenced by the TCu intrauterine contraceptive device.

    Science.gov (United States)

    Nilsson, O; Hagenfeldt, K

    1973-10-15

    Biopsies were taken from 3 healthy controls and 4 women who had used the Copper TCu device to determine the influence of the IUD on the secretory mechanism of the uterine epithelium. The normal endometrium possessed apical protrusions containing glycogen and its degradation products. Endometrial biopsies from women with an intrauterine Tatum-T device with copper had these protrusions infrequently. The reduction in apical protrusions was the one structural difference observed between control and TCu-influenced luminal epithelium. This finding might support the view that one effect of the TCu device is to interfere with the secretion of carbohydrates by the epithelium.

  11. Low-grade inflammation in young adults exposed to intrauterine hyperglycemia

    DEFF Research Database (Denmark)

    Kelstrup, Louise; Clausen, Tine Dalsgaard; Mathiesen, Elisabeth R

    2012-01-01

    AIM: To investigate associations between fetal exposure to intrauterine hyperglycemia and plasma concentrations of interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) in adult offspring. METHOD: We studied 597 offspring, aged 18-27years, from four different groups concerning......)) was positively associated with levels of both IL-6 and hs-CRP (p for both=0.003). Offspring who had already developed overweight or conditions of abnormal glucose tolerance were characterized by higher levels of IL-6 and hs-CRP compared with the remaining offspring (all p...

  12. Effectiveness of intrauterine treatment with cephapirin in dairy cows with purulent vaginal discharge.

    Science.gov (United States)

    Tison, N; Bouchard, E; DesCôteaux, L; Lefebvre, R C

    2017-02-01

    The objective of this study was to assess the efficacy of cephapirin intrauterine treatment preceding a timed artificial insemination protocol in lactating dairy cows with purulent vaginal discharges (PVDs). Holstein dairy cows (n = 1247) from 18 herds were enrolled in a controlled randomized clinical trial. At 34 days in milk (DIM; ±7 days), cows had a genital examination (transrectal palpation, vaginoscopy, and uterine bacteriology). They were randomly assigned to either the control group (CONT, no treatment) or the treatment group (CEPH) consisting of 1 intrauterine infusion of 500-mg cephapirin benzathine (RCL) (Metricure, Merck Animal Health, Montreal, Canada) regardless of the uterine health status. All cows were systematically enrolled in a presynch-ovsynch protocol for the first insemination. A second genital examination was made 2 weeks later. Cows that received any systemic or local antibiotics 10 days prior sampling to the end of the synchronization protocol were excluded from the study. Reproductive data of cows were collected for at least 300 DIM, entered in a databank, and validated (health record management software, DSAHR). Pregnancy diagnosis was done by transrectal palpation at the routinely scheduled veterinarian visits. On the basis of the highest sum of sensibility and specificity for pregnancy status at 120 DIM, the optimal cutoff for vaginal discharge score was determined as the presence of cloudy discharge with or without purulent material (PVD+, score 2). With a prevalence of 21.6% at 34 DIM, PVD+ was detrimental to the first-service conception rate (FSCR; PVD+: 26 ± 5%; PVD-: 40 ± 3%; P = 0.02). The negative effect of PVD+ was indicated by a hazard ratio of 0.72 (chi-square = 8.58; P < 0.01; 95% confidence interval = 0.56-0.91). Treatment with cephapirin was associated with a significant improvement of the FSCR in PVD+ cows (PVD+ CEPH: 36 ± 5%, PVD+ CONT: 23 ± 5%; P < 0.05), although it did not produce a

  13. Fetomaternal Hemorrhage following Placement of an Intrauterine Pressure Catheter: Report of a New Association

    Directory of Open Access Journals (Sweden)

    Fadi G. Mirza

    2015-01-01

    Full Text Available Fetomaternal hemorrhage (FMH can be associated with significant perinatal mortality. Our review of the literature did not identify any cases of FMH following placement of an intrauterine pressure catheter (IUPC. In our case, an IUPC was inserted in a patient undergoing induction of labor at term. Fetal bradycardia ensued shortly after placement, warranting an emergent cesarean delivery. Severe neonatal anemia was identified, and evaluation of maternal blood was consistent with massive FMH. This is the first reported association between FMH and IUPC placement. If this relationship is validated in future reports, appropriate changes in clinical practice may be warranted.

  14. Intrauterin insemination med donorsaed. Behandling af ufrivillig barnløshed på grund af mandlig infertilitet

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Helmsøe-Zinck, Lise; Andersen, A N

    1994-01-01

    Intrauterine insemination with cryopreserved donor semen was performed in 114 women in a total of menstrual 381 cycles during the period 1.2.1991 to 15.5.1993. Eighty-one pregnancies were recorded corresponding to a conception rate of 21% per insemination cycle. After ten cycles the probability...... of conception and expected delivery was respectively 96% and 86%. The results show that intrauterine insemination with donor semen is a good treatment for couples with male infertility. Ultrasonic measurement of the follicles and timing of hCG injection were used for optimal timing of intrauterine donor...... insemination. The quality of the semen used for insemination is important. It is recommended to inseminate with at least two million of spermatozoa where at least 20% have normal motility....

  15. The efficacy of intrauterine injection of human chorionic gonadotropin before embryo transfer in assisted reproductive cycles: Meta-analysis.

    Science.gov (United States)

    Ye, Hong; Hu, Jing; He, Wencong; Zhang, Yong; Li, Caihong

    2015-12-01

    A systematic review and meta-analysis to evaluate the effect of human chorionic gonadotropin (hCG) intrauterine injection before embryo transfer on the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Searches of PubMed®, EMBASE®, EBSCO, Web of Science®, SCOPUS® and Cochrane Central Register of Controlled Trials were conducted to retrieve relevant randomized controlled trials (RCTs). Data were extracted and analysed. The meta-analysis included five RCTs (hCG group n = 680; control group n = 707). Intrauterine hCG injection significantly increased rates of biochemical, clinical and ongoing pregnancy compared with controls. There were no between-group differences in implantation or miscarriage rates. Women undergoing IVF/ICSI may benefit from intrauterine hCG injection before embryo transfer. © The Author(s) 2015.

  16. Head Lice: Frequently Asked Questions (FAQs)

    Science.gov (United States)

    ... spread lice? Can swimming spread lice? What are head lice? The head louse, or Pediculus humanus capitis , ... spread disease. Who is at risk for getting head lice? Head lice are found worldwide. In the ...

  17. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    D. Bijlenga (Denise); K.E. Boers (Kim); E. Birnie (Erwin); B.W.J. Mol (Ben); S.C.M. Vijgen (Sylvia); J.A.M. van der Post (Joris); C.J.M. de Groot (Christianne); R.J.P. Rijnders (Robbert); P.J. Pernet (Paula); F.J.M.E. Roumen (Frans); R.H. Stigter (Rob); F.M.C. Delemarre (Friso); H.A. Bremer (Henk); M. Porath (Martina); S.A. Scherjon (Sico); G.J. Bonsel (Gouke)

    2011-01-01

    textabstractObjective: Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine

  18. Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Sussan S. Mohammadi

    2015-05-01

    Full Text Available Objectives: There are a number of potential advantages to performing hysteroscopy in an outpatient setting. However, the ideal approach, using local uterine anesthesia or rectal non-steroidal anti-inflammatory drugs, has not been determined. Our objective was to compare the efficacy of intrauterine lidocaine instillation with rectal diclofenac for pain relief during diagnostic hysteroscopy. Methods: We conducted a double-blind randomized controlled trial on 70 nulliparous women with primary infertility undergoing diagnostic hysteroscopy. Subjects were assigned into one of two groups to receive either 100mg of rectal diclofenac or 5mL of 2% intrauterine lidocaine. The intensity of pain was measured by a numeric rating scale 0–10. Pain scoring was performed during insertion of the hysteroscope, during visualization of the intrauterine cavity, and during extrusion of the hysteroscope. Results: There were no statistically significant differences between the groups with regard to the mean pain score during intrauterine visualization (p=0.500. The mean pain score was significantly lower during insertion and extrusion of the hysteroscope in the diclofenac group (p=0.001 and p=0.030, respectively. Nine patients in the lidocaine group and five patients in diclofenac group needed supplementary intravenous propofol injection for sedation (p=0.060. Conclusions: Rectal diclofenac appears to be more effective than intrauterine lidocaine in reducing pain during insertion and extrusion of hysteroscope, but there are no significant statistical and clinical differences between the two methods with regard to the mean pain score during intrauterine inspection.

  19. [Random comparative study between intrauterine device Multiload Cu375 and TCu 380a inserted in the postpartum period].

    Science.gov (United States)

    Lara Ricalde, Roger; Menocal Tobías, Gerardo; Ramos Pérez, Carlos; Velázquez Ramírez, Norma

    2006-06-01

    To evaluate safety and effectiveness of the intrauterine device Multiload Cu375 compared with the TCu 380A inserted in the postpartum period. In a randomized comparative study carried out in the National Perinatology Institute, intrauterine devices MLCu 375 and Tcu 380A were inserted to 157 patients who voluntary accepted, and previously signed informed consent. There were four instances for the intrauterine devices insertion: within 10 minutes after vaginal delivery, during cesarean section (immediate postplacental insertion) and postpartum-postcesarean insertion (in the time range of 10 min to 48 h). All insertions were made with ring forceps. From 1 h to 24 h later, abdominal ultrasound examinations were performed to assess the distances between the upper part of the device to the fundus of uterine cavity. Follow up visits were scheduled at 3, 6, 9 and 12 months. Net cumulative life table event rates of discontinuations were estimated at one year. The expulsion rates were 10.4 for the MLCu 375 and 7.7 for the TCu 380A and they were not influenced by the moment of the intrauterine device insertion, not by the cervical dilatation, neither by the distance of the intrauterine device to the fundus of uterine cavity. The removal rates for bleeding and pain were 4.9 and 4.8, the removal rates for non medical reasons were 3.7 and 4.9 respectively. There was one case of genital infection in the MLCu 375 group. There were no pregnancies, nor uterine perforation. The one year continuation rates were 77.1 and 82.6 respectively. There were no statistical significant differences in the comparative rates. The intrauterine device MLCu 375 is as safe and effective as the TCu380A when they are inserted in the postpartum period.

  20. IVF culture medium affects human intrauterine growth as early as the second trimester of pregnancy.

    Science.gov (United States)

    Nelissen, Ewka C M; Van Montfoort, Aafke P A; Smits, Luc J M; Menheere, Paul P C A; Evers, Johannes L H; Coonen, Edith; Derhaag, Josien G; Peeters, Louis L; Coumans, Audrey B; Dumoulin, John C M

    2013-08-01

    When does a difference in human intrauterine growth of singletons conceived after IVF and embryo culture in two different culture media appear? Differences in fetal development after culture of embryos in one of two IVF media were apparent as early as the second trimester of pregnancy. Abnormal fetal growth patterns are a major risk factor for the development of chronic diseases in adult life. Previously, we have shown that the medium used for culturing embryos during the first few days after fertilization significantly affects the birthweight of the resulting human singletons. The exact onset of this growth difference was unknown. In this retrospective cohort study, all 294 singleton live births after fresh embryo transfer in the period July 2003 to December 2006 were included. These embryos originated from IVF treatments that were part of a previously described clinical trial. Embryos were allocated to culture in either Vitrolife or Cook commercially available sequential culture media. We analysed ultrasound examinations at 8 (n = 290), 12 (n = 83) and 20 weeks' (n = 206) gestation and used first-trimester serum markers [pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG]. Differences between study groups were tested by the Student's t-test, χ(2) test or Fisher's exact test, and linear multivariable regression analysis to adjust for possible confounders (for example, parity, gestational age at the time of ultrasound and fetal gender). A total of 294 singleton pregnancies (Vitrolife group nVL = 168, Cook group: nC = 126) from 294 couples were included. At 8 weeks' gestation, there was no difference between crown-rump length-based and ovum retrieval-based gestational age (ΔGA) (nVL = 163, nC = 122, adjusted mean difference, -0.04 days, P = 0.84). A total of 83 women underwent first-trimester screening at 12 weeks' gestation (nVL = 45, nC = 38). ΔGA, nuchal translucency (multiples of median, MoM) and PAPP-A (MoM) did not differ between the study