Recommendations for Prenatal Doppler in Daily Obstetric Practice - A Review

Doppler fluximetry in obstetrics refers to the use of Doppler ultrasound technology to assess blood flow patterns and velocities in the maternal and fetal circulations during pregnancy. It provides valuable information about the vascular dynamics in the placenta, umbilical cord, and fetal organs, aiding in the evaluation of fetal well-being and the identification of potential complications. The umbilical artery, middle cerebral artery, and uterine artery are the blood vessels used in Doppler fluximetry to measure blood flow patterns and velocities. The parameters commonly assessed in Doppler fluximetry include: Systolic/Diastolic Ratios: The ratio of peak systolic velocity to end diastolic velocity, providing information about the resistance to blood flow. Pulsatility Index (PI): Calculated as the difference between peak systolic and end-diastolic velocities divided by the mean velocity, reflecting the resistance and compliance of the vessel. Resistance Index (RI): Calculated as the difference between peak systolic and end-diastolic velocities divided by the peak systolic velocity, assessing vascular resistance. By evaluating these parameters, Doppler fluximetry can provide insights into the uteroplacental and fetal circulations. Abnormal findings, such as increased resistance or altered blood flow patterns, may indicate placental insufficiency, fetal growth restriction, fetal anemia, or other complications. These findings can guide clinical management and help in making decisions regarding the timing and mode of delivery or further interventions. It’s essential to note that the interpretation of Doppler findings should always be done in conjunction with other clinical data, such as fetal growth assessment, maternal health, and fetal well-being. Doppler flowmetry should always be performed and interpreted by qualified healthcare professionals, such as obstetricians, perinatologists, or sonographers, who can integrate the Doppler findings with other clinical data to provide appropriate care for pregnant women

Quality of life in cancer patients – A systematic review

Background. Cancer is a significant health problem worldwide. Globally, cancer is one of the most common causes of morbidity and mortality and this is predicted to increase by at least 70% by 2030. The aim of this systematic review was to identify the state of the scientific evidence regarding the quality of life in patients. with cancer. Methods. The literature was searched in the Scopus, Web of Science and Pub Med databases, the literature related to the quality of life in cancer patients. Keywords are combined with Boolean operators (AND/OR). There are sixty studies were included in the current review. Results. The social and physical domains were the most endangered, while the environment was the most preserved. Comparison between scores showed a significant difference only in terms of self-rated health. The highest scores were found in the group with the best assessment of their health. The results suggest that self-rated health can be a reliable predictor of quality of life in these patients, being important for further studies on this topic. Discussion. The findings of this review indicate low QoL among cancer patients on anticancer therapy. Functional well-being was most affected among cancer patients, followed by emotional well-being among cancer patients on cancer therapy. From our study, it was found that the overall quality of life of the patients was influenced by the education and professional status of the patient. Unemployed and illiterate patients have worse QoL than employed and educated patients

The Prevalent Cases of Endometrial Carcinoma in Different Life Periods of Women – Clinical and Histopathological Diagnosis

Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman’s normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women’s lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding

Harlequin Ichthyosis – Genetic and Dermatological Challenges: A Case Report and Literature Review

Harlequin ichthyosis (HI) is an extremely rare and severe genetic skin disorder characterized by thick, diamond-shaped scales covering the body, often giving the appearance of a harlequin costume. This paper provides an overview of the genetic and dermatological aspects of HI, delving into its etiology, clinical manifestations, and management. The genetic underpinnings of HI involve mutations in the ABCA12 gene, leading to impaired skin barrier function and abnormal keratinization. Understanding the molecular basis of the disorder is crucial for accurate diagnosis and potential therapeutic interventions. Clinically, HI presents challenges related to skin integrity, thermoregulation, and potential complications, such as infections. The management of HI requires a multidisciplinary approach involving dermatologists, geneticists, and other healthcare professionals. Supportive care, including emollients, careful bathing, and prevention of infections, is essential to improve the quality of life for individuals affected by this condition. Despite its rarity and severity, advancements in medical research and genetic therapies offer hope for improved treatments and interventions. This paper aims to contribute to the collective understanding of HI, fostering ongoing research and compassionate care for those living with this unique and challenging dermatological condition. We presented a premature eutrophic harlequin baby, born at 32+ weeks of gestation via emergency C-section. A clinical diagnosis was established minutes after birth, based on the typical features of HI, from scaly skin, marked fissures, and limbs in flexion contractures to prominent eclabium and bilateral ectropion

Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

<p>Abstract</p> <p>Introduction</p> <p>The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception.</p> <p>Case presentation</p> <p>A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum.</p> <p>Conclusions</p> <p>Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.</p

Trichomonas Vaginalis-A Clinical Image

A 32-year-old G4P301LC3 woman presents to the office for a visit, with a 6-day history of vaginal discharge with an unpleasant odor. On speculum examination, the discharge was green in color and frothy in appearance. Is noticed vulvar erythema, edema, and pruritus, also is noted the characteristic erythematous, punctate epithelial papillae or &ldquo;strawberry&rdquo; appearance of the cervix. Vaginal pH was 6.2. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs.But also, for diagnosis help even the exam with the speculum, concretely &ldquo;strawberry&rdquo; appearance of the cervix. The diagnosis is confirmed by culture.Trichomoniasis is a sexually transmitted infection [1,2], that caused by trichomonas vaginalis. Trichomonas vaginalis is a unicellular, anaerobic flagellated protozoan, that inhabits the lower genitourinary tracts of women and men, but that can cause vaginitis. Clinical findings of Trichomonas vaginalis include a profuse discharge with an unpleasant odor. The discharge may be yellow, gray, or green in color and may be frothy in appearance. Vaginal pH is in the 6 to 7.Vulvar erythema, edema, and pruritus can also be noted. The characteristic erythematous, punctate epithelial papillae or &ldquo;strawberry&rdquo; appearance of the cervix is apparent in only 10% of cases. Symptoms are usually worse immediately after menses because of the transient increase in vaginal pH at that time. Diagnosis of Trichomonas vaginalis is made via wet prep microscopic examination of vaginal swabs. Other, more sensitive tests are available, including nucleic acid probe study and immunochromatographic capillary flow dipstick technology. The diagnosis can be confirmed when necessary with culture, which is the most sensitive and specific study. Nucleic acid amplification tests (NAATs) have replaced culture as the gold standard. T vaginalis NAATs have been validated in asymptomatic and symptomatic women and are a highly sensitive test [3]. Because the Trichomonas vaginalis is a sexually transmitted infection, both partners should be treated to prevent reinfection. The mainstay of treatment for Trichomonas vaginalis infections is metronidazole. Treatment schemes can be

Unintended Consequences: Exploring Iatrogenic Injuries in Cesarean Section Deliveries

Cesarean delivery (CD), or C-section, which prevents injury and death in mothers and babies at higher risk of complicated deliveries, like any surgery, does carry a risk of complications. By reviewing the medical literature and analyzing documented CD cases, we examined the spectrum of iatrogenic injuries, including unintentional injuries, affecting both maternal and neonatal outcomes. This case report describes iatrogenic bladder damage after CD in a 31-year-old woman who had a previous emergency CD two years ago. This case calls for a comprehensive approach to minimize iatrogenic risks and optimize maternal and neonatal well-being during repeat СD

BORDERLINE OVARIAN TUMOR AND PREGNANCY

We present a case of a 26 year-old pregnant woman, who was diagnosed a serous borderline tumor of the ovary, two years ago. CA 125, CA 19-9 and HE4 was within the normal range values. A Cystectomy was performed, where too histopathological diagnosis was decided. The patient was informed in detail about the nature of the disease and the treatment methods, and was assigned the time of surgical intervention (unilateral salpingo-oophorectomy with staging has been recommended), she does not accept any treatment method. After a year of follow-up with tumor markers, an exploratory laparoscopy with ovarian biopsy was performed. Left ovary was without histopathological changes, while the right ovary had histopathological changes for serous borderline tumor of the ovary, but without storm invasion. She decided for surgery. Fifteen days before surgery, she is presented for a routine visit, where pregnancy was confirmed. She was informed about potential risk, but categorically decided to continue the pregnancy. During pregnancy, there was no complication. She is presented for birth at 39+5 weeks of gestation. Due to obstetric status, which is not conducive to vaginal delivery and previous diagnoses, in co-think with the patient, it is decided that birth should be performed with Caesarean section. During a C - section, both ovaries are inspected, there are no macroscopic changes. Biopsy was obtained in both ovaries. The result was the same as two years ago. Because of the scarce studies, it is difficult to know which are the best management practices and especially to women who desire childbearing

Neurofibromatosis Type 1 (Nf1) and Pregnancy - Case With Positive Outcomes

Apregnancy is categorized as with high-risk when the life of the mother or the fetus becomes fragile due to various diseases. Many health problems can be manifested in women before pregnancy, during and after pregnancy. Some health problems can also begin in early adolescence with very light clinical signs, but during pregnancy because of the hormonal changes that may occur, lead to intensification of the disease. We report the management of a 26-year-old woman patient diagnosed with neurofibromatosis 1 (NF1), without any complications during pregnancy and childbirth