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Fetal and surgery

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https://www.readbyqxmd.com/read/29665170/breast-carcinoma-in-pregnancy-with-spheroid-like-placental-metastases-a-case-report
#1
Karolin Froehlich, Hanne Stensheim, Udo R Markert, Gitta Turowski
Breast cancer is one of the most common malignancies diagnosed in pregnancy. Although the tumor is often detected at an advanced stage, placental metastases are rare. Here, we describe the case of a woman with breast cancer recurrence during pregnancy and subsequent metastases. The focus of this study is the large amount of placenta metastases, which have been analyzed immunohistochemically. Staining with trophoblast markers (placenta alkaline phosphatase, beta human chorionic gonadotropin and human placental lactogen) showed the strict localization of metastases in the intervillous space without invasion into fetal tissue...
April 17, 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#2
REVIEW
Kevin X Cao, Alice Booth, Sebastien Ourselin, Anna L David, Richard Ashcroft
The specialty of fetal surgery or fetal intervention is one of the most exciting emerging fields of modern medicine. It is made possible by decades of major developments in antenatal imaging, obstetric anaesthesia, fetal medicine, paediatric surgery and of course by the bold and novel practitioners willing to take new steps to advance the field. Beginning in the 1970s it has now reached a stage of maturity where there are several established in-utero procedures and countless clinical trials and studies to develop more...
April 16, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29660361/maternal-and-fetal-outcome-after-cardiac-surgery-during-pregnancy-a-meta-analysis
#3
REVIEW
Nivedita Jha, Ajay Kumar Jha, Ramesh Chand Chauhan, Neelima Singh Chauhan
BACKGROUND: In the past, cardiac surgery during pregnancy has been associated with high risk of adverse maternal and fetal outcomes. Therefore, this meta-analysis was done to assess the fetomaternal risk after cardiac surgery during pregnancy using cardiopulmonary bypass in more recent studies. METHODS: The Medline, Embase and Cochrane library were searched to find studies from January 1 1990 to July 31 2016 without language restriction. We selected studies that included at least four women to report fetomaternal outcomes after cardiac surgery using cardiopulmonary bypass during pregnancy...
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29652283/mitral-valve-repair-in-infective-endocarditis-during-pregnancy
#4
Takahiro Tamura, Shuichi Yokota
Infective endocarditis (IE) during pregnancy and subsequent cardiac surgery are rare and associated with a high risk of mortality for the mother and fetus. It is difficult to determine the right time for cardiac intervention when IE is diagnosed early in pregnancy. A 33-year-old previously healthy woman in the 11th week of pregnancy was diagnosed with IE and underwent surgical intervention. The cardiopulmonary bypass settings and the anesthetic drugs were carefully chosen. Although she was in good health, while being discharged, the fetus did not survive...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652282/perioperative-management-of-transcatheter-aortic-and-mitral-double-valve-in-valve-implantation-during-pregnancy-through-left-ventricular-apical-approach
#5
Suresh Chengode, Rahul Vijaykumar Shabadi, Ram Narayan Rao, Nasser Alkemyani, Hilal Alsabti
Pregnant women with stenotic degeneration of bioprosthetic cardiac valves may require another valve replacement procedure when their symptoms deteriorate with progression of pregnancy, but fetal mortality is higher with cardiac surgery done on cardiopulmonary bypass. Transcatheter valve-in-valve implantation may help to improve the fetal and maternal outcomes in these situations. Double valve-in-valve implantation is rare and has not been reported in a pregnant patient. We report, for the first time, the case of a pregnant woman with stenotic bioprosthetic valves in the mitral and aortic positions, who underwent a successful concomitant, transcatheter, double valve-in-valve implantation through the left ventricular apical route during the second trimester of her precious pregnancy...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29651556/neurospheres-from-neural-stem-neural-progenitor-cells-nspcs-of-non-hydrocephalic-htx-rats-produce-neurons-astrocytes-and-multiciliated-ependyma-the-cerebrospinal-fluid-of-normal-and-hydrocephalic-rats-supports-such-a-differentiation
#6
Roberto Henzi, Montserrat Guerra, Karin Vío, César González, Cristian Herrera, Pat McAllister, Conrad Johanson, Esteban M Rodríguez
Fetal onset hydrocephalus and abnormal neurogenesis are two inseparable phenomena turned on by a cell junction pathology first affecting neural stem/progenitor cells (NSPCs) and later the multiciliated ependyma. The neurological impairment of children born with hydrocephalus is not reverted by derivative surgery. NSPCs and neurosphere (NE) grafting into the cerebrospinal fluid (CSF) of hydrocephalic fetuses thus appears as a promising therapeutic procedure. There is little information about the cell lineages actually forming the NE as they grow throughout their days in vitro (DIV)...
April 12, 2018: Cell and Tissue Research
https://www.readbyqxmd.com/read/29649044/oval-window-size-and-shape-a-micro-ct-anatomical-study-with-considerations-for-stapes-surgery
#7
Matthew J Zdilla, Janusz Skrzat, Magdalena Kozerska, Bartosz Leszczyński, Jacek Tarasiuk, Sebastian Wroński
BACKGROUND: The oval window is an important structure with regard to stapes surgeries, including stapedotomy for the treatment of otosclerosis. Recent study of perioperative imaging of the oval window has revealed that oval window niche height can indicate both operative difficulty and subjective discomfort during otosclerosis surgery. With regard to shape, structures incorporated into the oval window niche, such as cartilage grafts, must be compatible with the shape of the oval window...
April 11, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29606013/evaluation-of-pre-and-postnatally-diagnosed-gastrointestinal-tract-obstructions
#8
Gokcen Orgul, Tutku Soyer, Murat Yurdakok, MSinan Beksac
PURPOSE: Signs of congenital obstruction of the gastrointestinal tract (GIT) organs may present on prenatal ultrasonography. Prenatal detection is influenced by several factors, including obstruction site, lesion degree (partial or complete), the occurrence of associated malformations, and gestational week at screening. Here, we aimed to evaluate the success of prenatal diagnosis of GIT obstructions in a tertiary center in Turkey. MATERIAL AND METHODS: The study included 34 prenatally and 22 postnatally diagnosed babies with different GIT malformations...
March 31, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29593991/uterine-rupture-in-a-primigravid-patient-with-an-unscarred-bicornuate-uterus-at-term
#9
Brad Nitzsche, Maggie Dwiggins, Susan Catt
Background: Uterine rupture of an unscarred primigravid uterus is an exceedingly rare event. Cases of spontaneous rupture of an unscarred bicornuate uterus have been reported, but typically occur in the first or second trimester. Case: A 28-year-old primigravida at 37 weeks gestation with a known bicornuate uterus and no prior surgery underwent an emergent cesarean section after presenting with severe abdominal pain and signs of fetal compromise. She was found to have a uterine rupture with the fetus free in the abdomen accompanied by a large hemoperitoneum...
July 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29580731/active-surveillance-for-antenatally-detected-ureteroceles-predictors-of-success
#10
V Andrioli, L Guerra, M Keays, D T Keefe, K Tang, K J Sullivan, K Garland, M Rafikov, M P Leonard
INTRODUCTION: Historically, ureteroceles were surgically treated, as patients were diagnosed after developing symptoms. However, with the advance of fetal medicine, antenatal detection has provided an opportunity to look at the natural history of ureteroceles. OBJECTIVES: With data derived from a retrospective chart review of patients with ureteroceles that were detected antenatally, the current study aimed to determine which group of children would be at risk for failure on active surveillance...
March 13, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29574986/outcome-of-pregnancies-in-a-large-cohort-of-women-with-acromegaly
#11
R S Jallad, I Shimon, M Fraenkel, V Medvedovsky, A Akirov, F H Duarte, M D Bronstein
OBJECTIVE: To assess the outcome of pregnancies in a large cohort of women with acromegaly. DESIGN AND METHODS: This is a retrospective analysis of 31 pregnancies in 20 acromegalic patients. RESULTS: Twenty-seven pregnancies resulted in healthy offspring and four resulted in abortion. Three patients underwent transsphenoidal surgery during pregnancy. IGF-1 levels remained elevated during pregnancy in four pregnancies and normalized in 23 cases...
March 25, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29551244/surgical-outcomes-of-patients-with-beckwith-wiedemann-syndrome
#12
Candace C Style, Stephanie M Cruz, Patricio E Lau, Timothy C Lee, David E Wesson, Oluyinka O Olutoye
PURPOSE: The purpose of this study was to evaluate treatment and surgical outcomes of patients of Beckwith-Wiedemann Syndrome (BWS) treated at a tertiary children's hospital. METHODS: A retrospective review of infants evaluated at Texas Children's Hospital for BWS from August 2000 to December 2016 was performed. Data collected included demographic information, clinical presentation, genetic evaluation, fetal imaging, operative treatment, and outcomes. RESULTS: Forty-seven children with a diagnosis of BWS were identified...
February 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29551093/emergency-video-assisted-thoracic-surgery-for-ruptured-pulmonary-arteriovenous-malformation-related-hemothorax-in-a-pregnant-woman-a-case-report
#13
Hu-Lin Christina Wang, Jia-Hao Zhang, Cheng-Hung How
BACKGROUND: Pulmonary arteriovenous malformations are rare vascular abnormalities that permit direct communication between the pulmonary artery and vein. During pregnancy, pulmonary arteriovenous malformation carries an increased risk of enlargement and rupture, which could lead to life-threatening hemothorax. This is the first case reporting successful thoracoscopic surgery for a pregnant woman with pulmonary arteriovenous malformation rupture-related hemothorax. CASE PRESENTATION: We present a case of a 32-year-old pregnant Asian woman (31 weeks' gestation) whose pulmonary arteriovenous malformation ruptured, leading to right-sided spontaneous tension hemothorax...
March 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29541801/morphometric-properties-of-the-levator-scapulae-rhomboid-major-and-rhomboid-minor-in-human-fetuses
#14
Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29540763/fetal-extracellular-matrix-nerve-wraps-locally-improve-peripheral-nerve-remodeling-after-complete-transection-and-direct-repair-in-rat
#15
Tanchen Ren, Anne Faust, Yolandi van der Merwe, Bo Xiao, Scott Johnson, Apoorva Kandakatla, Vijay S Gorantla, Stephen F Badylak, Kia M Washington, Michael B Steketee
In peripheral nerve (PN) injuries requiring surgical repair, as in PN transection, cellular and ECM remodeling at PN epineurial repair sites is hypothesized to reduce PN functional outcomes by slowing, misdirecting, or preventing axons from regrowing appropriately across the repair site. Herein this study reports on deriving and analyzing fetal porcine urinary bladder extracellular matrix (fUB-ECM) by vacuum assisted decellularization, fabricating fUBM-ECM nerve wraps, and testing fUB-ECM nerve wrap biocompatibility and bioactivity in a trigeminal, infraorbital nerve (ION) branch transection and direct end-to-end repair model in rat...
March 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29539628/prenatal-abo-rhd-genotyping-a-new-paradigm-to-allow-for-fresh-whole-blood-for-cardiopulmonary-bypass-in-the-immediate-newborn-period
#16
Juliet Chhay Bishop, Karin Blakemore, Luca Vricella, Priya Sekar, Katelynn Sagaser, Jude Crino, Paul Ness, Benjamin K Kogutt, Joan Boyd, Susan Aucott, Angie C Jelin, Joanne Chiu, Eric Gehrie, Kristen Nelson McMillan
Compared to standard component therapy, fresh whole blood (FWB) offers potential benefits to neonates undergoing cardiopulmonary bypass (CPB) in the context of open cardiac surgery: decreased blood loss and subsequent risk of volume overload, improved coagulation status, higher platelet counts during and following CPB, circumvention of limited vascular access, and significantly reduced donor exposures. Obtaining FWB, however, entails 2-5 days of preparation, which often precludes its availability for neonates requiring CPB in the immediate newborn period...
March 14, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29534823/a-retrospective-multicenter-study-of-the-natural-history-of-fetal-ovarian-cysts
#17
Athanasios Tyraskis, Spyros Bakalis, Carolina Scala, Argyro Syngelaki, Stefano Giuliani, Mark Davenport, Anna L David, Kypros Nicolaides, Simon Eaton, Paolo De Coppi
AIM: We investigated the natural history of fetal ovarian cysts to estimate the risk of torsion according to size. METHODS: Cases were identified from 1/1/2000 until 1/1/2015. Data were collected pre- and postnatally on cyst size and sonographic features until an outcome of surgery, torsion, or resolution. Fisher's exact test for categorical data and logistic regression for continuous data were used to test the significance of size on torsion; P value <0.05 was considered significant...
February 12, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29530664/vulvar-field-resection-based-on-ontogenetic-cancer-field-theory-for-surgical-treatment-of-vulvar-carcinoma-a-single-centre-single-group-prospective-trial
#18
Michael Höckel, Sophia Trott, Nadja Dornhöfer, Lars-Christian Horn, Bettina Hentschel, Benjamin Wolf
BACKGROUND: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer...
April 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29523633/management-of-endocrine-disease-management-of-cushing-s-syndrome-during-pregnancy-solved-and-unsolved-questions
#19
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29522295/on-thin-ice-barriers-to-adoption-of-surveillance-for-patients-with-stage-i-testicular-seminoma-survey-of-us-radiation-oncologists
#20
Aditya Jain, Catherine Degnin, Yiyi Chen, Mike Craycraft, Arthur Hung, Jerry Jaboin, Charles R Thomas, Timur Mitin
PURPOSE: Most men with stage I testicular seminoma are cured with surgery alone, which is a preferred strategy per national guidelines. The current pattern of practice among US radiation oncologists (ROs) is unknown. MATERIALS AND METHODS: We surveyed practicing US ROs via an online questionnaire. Respondent's characteristics, self-rated knowledge, perceived patient compliance rates with observation were analyzed for association with treatment recommendations. RESULTS: We received 353 responses from ROs, of whom 23% considered themselves experts...
March 9, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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