Nėštumas cezario pjūvio rande: klinikinio atvejo pristatymas ir literatūros apžvalga.

Bacground. Pregnancy in the cesarean section scar is one of the rarest forms of ectopic pregnancy accounting for about 6.1% of all ectopic pregnancies in women who have previously had a cesarean section. Removal of the condition can be treated with medication, surgery, or a combination of the two. Case report. A forty-year-old woman presented to the Emergency Department for lower abdominal pain. A life history marks one pregnancy completed by caesarean section. The pregnancy test was positive. The concentration of human chorionic gonadotropin (hCG) was 1810 IU/l. A vaginal ultrasound performed at the next visit revealed a 1.0 cm diameter gestational sac at the isthmus of the uterus. 5 weeks pregnancy was confirmed, hCG-5391 IU/l. 3 weeks later a transvaginal ultrasound examination revealed a 10 mm diameter echonegative shadow with a thick capsule in the cesarean section site. Caesarean scar pregnancy was diagnosed. Surgical laparoscopy was performed to remove the cesarean scar pregnancy. Within 24 hours after the operation, hCG levels decreased from 5391 to 1189 IU/l. Conclusion. Minimally invasive intervention laparoscopy is an effective treatment method with a low risk of complications in the case of pregnancy in the cesarean section scar. Universal treatment guidelines could ensure more successful treatment of this condition

The value of low dose provocation test in the diagnosis of non-immediate iodinate contrast media hypersensitivity

Background: Iodinated contrast media enhance the visibility of vascular structures and organs during radiographic procedures. Although generally considered safe, it is the third leading cause of cutaneous drug reactions. Iodinated contrast media is one of the most frequently used drugs in diagnostic medicine, but non-immediate hypersensitivity reactions are believed to be underreported because of delayed onset, which makes recognising and diagnosing these reactions challenging. For this reason, it is important to raise awareness about non-immediate hypersensitivity reactions to iodinated contrast media in the medical society. Case Reports: We present two case reports of non-immediate hypersensitivity reaction to iodinated contrast media after the first exposure. Patient I reacted to iohexol and iopromide with fixed drug eruption. Patient II reacted to iodixanol with a maculopapular rash on the chest and abdomen, Quincke’s oedema in her face and neck. Both patients had negative skin testing (prick, intradermal and patch test), but drug provocation test confirmed the allergy to iodixanol for Patient II. Patient I underwent premedication before re-exposure to iodinated contrast media, but it was unsuccessful. Histological examination of eruptions of both patients showed dermatitis, usual for drug hypersensitivity. Conclusion: In this article, we demonstrate the importance of drug provocative test as well as limitations of skins tests and premedication

Suspected rivaroxaban-induced anaphylaxis secondary to ingestion of rivaroxaban and nimesulide without cross-reactivity to dabigatran – a case report /

Here, we describe a case of anaphylaxis secondary to rivaroxaban in a 61-year-old woman 24 hours after orthopedic surgery. 10–15 minutes after ingestion of rivaroxaban and nimesulide, the patient’s palms started itching, her face and lips swelled, her face flushed, she developed shortness of breath and subsequently lost consciousness. Serum tryptase levels at the time of the anaphylactic reaction were elevated, with subsequent measurement one month later returning a value within the normal range. Dabigatran and meloxicam were identified as suitable alternative drugs by oral provocation at an allergy clinic. Even though rivaroxaban rarely causes serious allergic reactions, when prescribing it, it is important to analyze patients’ medical history for possible previously experienced drug-induced allergic reactions and to be aware of the risks of possible undesired drug interactions

Mobile health app for monitoring allergic rhinitis and asthma in real life in Lithuanian MASK‐air users

Abstract Background: MASK‐air® is an app whose aim is to reduce the global burden of allergic rhinitis (AR) and asthma. A transfer of innovative practices was performed to disseminate and implement MASK‐air® in European regions. The aim of the study was to examine the implementation of the MASK‐air® app in Lithuanian adults in order to investigate (i) the rate of acceptance in this population, (ii) the duration of app use and (iii) the evaluation of the app after its use. Methods: In a longitudinal study, Lithuanian adults with AR and/or asthma were recruited by allergists. They were informed about how to use MASK‐air® and were followed closely. They were reviewed after one to 3 months to evaluate satisfaction and were asked to continue using the app. Results: Among the 149 patients recruited (37.2 � 10.4 years), 52.4% had rhinitis alone, 42.9% had rhinitis, asthma and/or conjunctivitis multimorbidity, and 2.7% isolated asthma. According to the MASK‐air® baseline questionnaire, 88.3% of patients considered that their symptoms were troublesome. Data were available for 102 (68.4%) patients. The duration of app usage in patients ranged from 1 to 680 days (median, 25–75 percentile: 54, 23.2–151 days). Forty‐two (41.1% of patients who were reviewed) patients agreed to share their opinion on MASK‐air®. Most users of the app were satisfied, from 46.5% thinking their allergy was treated more successfully to 90.4% recommending this app to other allergy sufferers. Discussion: When recommended by physicians, MASK‐air® was used for a longer period of time

The mundane experience of everyday calorie trackers: Beyond the metaphor of Quantified Self

This paper was accepted for publication in the journal New Media and Society and the definitive published version is available at https://doi.org/10.1177/1461444817698478In this article, we build on the work of Ruckenstein and Pantzar (2015), who have demonstrated how our understanding of self-tracking has been influenced by the metaphor of the Quantified Self (QS). To complicate this very selective picture of self-tracking, we shift the focus in understanding self-tracking from members of the QS community to the experiences of ‘ordinary man and woman’ (Bakardjieva and Smith, 2001). We, therefore, interviewed ‘everyday calorie trackers’, people who had themselves started using MyFitnessPal calorie counting app but were not part of any tracking community. Our analysis identifies three main themes – goals, use and effect – which highlight the mundane side of self-tracking, where people pursuing everyday, limited goals engage in basic self-tracking and achieve temporary changes. These experiences contrast with the account of self-tracking in terms of long-term, experimental analysis of data on the self or ‘biohacking,’ which dominates the QS metaphor in the academic literature