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Risque infectieux sous inhibiteur du checkpoint : une série de 10 cas et mise en place d’une stratégie de prévention. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Réponse prolongée d’un carcinome épidermoïde cutané métastatique réfractaire avec l’association cétuximab/pembrolizumab. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Traitement des patients atteints d’un mélanome métastatique cérébral par ipilimumab à haute dose et radiochirurgie : résultats à 5 ans. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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[Nodulocystic eruption induced by sorafenib]. Ann Dermatol Venereol 2019; 146:646-654. [PMID: 31362839 DOI: 10.1016/j.annder.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 12/22/2018] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Sorafenib is a multikinase inhibitor used in the treatment of hepatocellular carcinoma, advanced renal cell carcinoma, and differentiated thyroid carcinoma. Cutaneous adverse events are numerous and occur frequently. PATIENTS AND METHODS We present two cases of nodulocystic lesions associated with comedones in patients treated with sorafenib for hepatocellular carcinoma. In the first patient, a 64-year-old man, lesions appeared on the trunk one year after beginning sorafenib. Histopathological examination revealed a non-granulomatous, perivascular and perisudoral polymorphic cellular infiltrate associated with comedones and microcysts. These lesions progressed via inflammatory episodes interrupted by long periods of spontaneous remission without any specific treatment. In the second patient, a 53-year-old woman, a rash appeared on the buttocks three months after starting sorafenib and then spread to the lumbar region and thighs. Histopathological examination was consistent with granulomatous acne lesions. The initial treatment (oral tetracycline and zinc) given for 3 months proved ineffective. Patient follow-up over 3 years showed gradual regression without the appearance of any further lesions. DISCUSSION In the literature, several reports discuss acneiform rashes in patients treated with targeted therapy. In most cases, these lesions were papulopustular without retentional lesions. There are few reports of nodulocystic eruptions associated with comedones following sorafenib therapy. The mechanisms of emergence of these lesions seem to involve inhibition of the RAF pathway, C-KIT, and the PDGF signaling pathway.
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The rationale of opportunistic bilateral salpingectomies (OBS) during benign gynaecological and obstetric surgery: a consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG). Facts Views Vis Obgyn 2019; 11:177-187. [PMID: 31824638 PMCID: PMC6897518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Ovarian cancer (OC), is a disease difficult to diagnose in an early stage implicating a poor prognosis. The 5-year overall survival in Belgium has not changed in the last 18 years and remains 44 %. There is no effective screening method (secondary prevention) to detect ovarian cancer at an early stage. Primary prevention of ovarian cancer came in the picture through the paradigm shift that the fallopian tube is often the origin of ovarian cancer and not the ovary itself. Opportunistic bilateral salpingectomy (OBS) during benign gynaecological and obstetric surgery might have the potential to reduce the risk of ovarian cancer by as much as 65 %. Bilateral risk-reducing salpingectomy during a benign procedure is feasible, safe, appears to have no impact on the ovarian function and seems to be cost effective. The key question is whether we should wait for a RCT or implement OBS directly in our daily practice. Guidelines regarding OBS within our societies are therefore urgently needed. Our recommendation is to inform all women without a child wish, undergoing a benign gynaecological or obstetrical surgical procedure about the pro's and the con's of OBS and advise a bilateral salpingectomy. Furthermore, there is an urgent need for a prospective registry of OBS. The present article is the consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG) regarding OBS.
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Actualisation des données concernant le mélanome stade III : nouvelles recommandations du groupe français de cancérologie cutanée. Ann Dermatol Venereol 2019; 146:204-214. [DOI: 10.1016/j.annder.2019.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/15/2019] [Indexed: 11/16/2022]
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Vismodégib en traitement néoadjuvant du carcinome basocellulaire localement avancé : premiers résultats de l’essai de phase 2 multicentrique VISMONEO. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Efficacité et tolérance du mébutate d’ingénol dans le mélanome de Dubreuilh in situ de la face : étude pilote, de phase II prospective et multicentrique indiquant aucun bénéfice. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Traitement néoadjuvant par chimiothérapie intra-lésionnelles par 5-fluorouracil de kératoacanthomes : à propos de 12 cas. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Radiothérapie de contact dans le traitement de carcinomes périoculaires : résultats carcinologiques et cosmétiques du centre Léonard-de-Vinci de Dechy. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Radiothérapie de contact pour les carcinomes péri-oculaires : résultats carcinologiques et cosmétiques du centre Léonard-de-Vinci de Dechy. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fasciite à éosinophiles invalidante sous pembrolizumab. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Association radiothérapie et immunothérapie dans le traitement du mélanome localement avancé : un effet pseudo-abscopal ? Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Psoriasis aggravé sous traitement par nivolumab dans le cadre d’un mélanome métastatique. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Un érythème polymorphe (EP) induit par le virus Epstein-Barr (EBV) avec complications multiples. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Variabilité intra-individuelle du profil mutationnel d’un mélanome métastatique. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Colite grave sous ipilimumab : une contre-indication aux anti-PD1 ? Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Une maladie bulleuse tardive. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Efficacité et tolérance d’un traitement intermittent par vismodégib (1 semaine sur 4) dans le traitement de carcinomes basocellulaires non résécables. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Traitement des carcinomes basocellulaires du nez par radiothérapie de contact : expérience du centre Léonard de Vinci de Douai. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Réinjection de lymphocytes du donneur après allogreffe pour un mycosis fongoïde réfractaire. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Contactothérapie dans le traitement des carcinomes basocellulaires du nez : expérience du centre Léonard-de-Vinci de Dechy. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Quand la toxidermie n’est pas limitée aux extrémités. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Survenue de crampes sous vismodégib dans la prise en charge des carcinomes basocellulaires : étude prospective d’après l’expérience du CHRU de Lille chez 25 patients. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Limitation et arrêt des thérapeutiques dans le mélanome métastatique du sujet jeune. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Un effet indésirable inhabituel du sorafénib. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Concentrations du vémurafénib dans le liquide céphalo-rachidien (LCR) et le plasma : à propos de six patients. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Réintroduction d’inhibiteurs de BRAF dans le mélanome métastatique en situation d’impasse thérapeutique. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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[A "tattooed" lymph node mimicking metastatic melanoma]. Ann Dermatol Venereol 2013; 140:802-4. [PMID: 24315229 DOI: 10.1016/j.annder.2013.09.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 07/21/2013] [Accepted: 09/03/2013] [Indexed: 11/29/2022]
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[Limbic encephalitis: a new paraneoplastic auto-immune manifestation associated with metastatic melanoma?]. Ann Dermatol Venereol 2013; 140:278-81. [PMID: 23567229 DOI: 10.1016/j.annder.2013.01.424] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 12/01/2012] [Accepted: 01/11/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Several studies indicate an association between immune-related manifestations and prolonged survival in metastatic melanoma. Limbic encephalitis driven by immune-mediated disorders may also be observed during the course of certain cancers. PATIENTS AND METHODS In November 2009, a 60-year-old woman followed up for metastatic melanoma since July 2005 developed rapidly progressive cognitive disorder. Clinical, biological, MRI and electroencephalogram abnormalities resulted in diagnosis of probably paraneoplastic limbic encephalitis in a context of immune-related manifestations although chemotoxicity could not be ruled out. Auto-immunity with hypothyroidism and thrombocytopenia were seen concomitantly. DISCUSSION To the best of our knowledge, this is the first reported case of probably paraneoplastic limbic encephalitis associated with melanoma, a new example of an immune-related condition associated with prolonged survival in metastatic melanoma.
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Un ganglion « tatoué » mimant une métastase de mélanome. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.09.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Nouvelle toxicité de l’ipilimumab : une éosinophilie majeure. Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carcinome de Merkel : carcinome radio-induit ? Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.10.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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[Detection of melanoma relapse: a retrospective study of 100 patients]. Ann Dermatol Venereol 2009; 136:767-71. [PMID: 19917428 DOI: 10.1016/j.annder.2009.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 09/01/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is no international consensus on practical methods of monitoring melanoma following surgical removal of a primary tumour. The chief aim of such monitoring is to ensure detection of relapse where early diagnosis is crucial for survival (i.e. in-transit and lymph node metastases amenable to surgical removal) and the emergence of any first recurrence of primary melanoma. AIM The aim of our study was to identify the role of various agents and diagnostic tools both in first recurrence of primary melanoma and in clinical relapse of melanoma. PATIENTS AND METHODS This was a retrospective study covering all patients with in-transit or regional lymph node metastasis seen between January 2005 and December 2007. The type of recurrence and method of detection were studied. RESULTS Ninety-four patients presented recurrence, with 66% of relapses comprising regional lymph node metastasis and 34% consisting of in-transit metastases. Thirty-three percent of cases of recurrence were detected by patients themselves, 21% by our department, 22% by a private dermatologist, 18% by a radiologist and 6% by a general practitioner. Fifty-four percent of recurrences among patients aged under 50 years were self-detected compared to 18% among patients aged over 70 years. A second melanoma was detected in six patients. DISCUSSION This study underscores the great importance of self-examination in melanoma follow-up with over one third of recurrences being self-detected by patients. Self-examination was more effective for younger patients, emphasizing the need to increase awareness among older patients. This study also demonstrates the essential part played by dermatologists in terms of regular follow-up of melanoma.
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Pelvic inflammatory disease due to Streptococcus pneumoniae: a usual pathogen at an unusual place. Acta Clin Belg 2008; 63:398-401. [PMID: 19170357 DOI: 10.1179/acb.2008.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We report three cases of pelvic inflammatory disease (PID) due to Streptococcus pneumoniae in previously healthy young women. S. pneumoniae frequently causes bacteremia, meningitis and respiratory infections, but it very rarely infects the genital tract. All our patients presented with an acute onset of severe abdominal pain and had an intrauterine device (IUD) present. No abnormal sexual behavior was noticed. Although the relation between PID due to S. pneumoniae and the use of an IUD has been a topic for discussions, culture of IUD in all our patients and blood culture in 2 of 3 of our patients revealed S. pneumoniae. All patients recovered well with intravenous antibiotic treatment and removal of the IUD.
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Abstract
AIMS The aim of the study is to examine the disinfection of wood contaminated with Paenibacillus larvae subsp. larvae spores, in order to find a practical decontamination method for hive materials. METHODS AND RESULTS The number of viable spores recovered after the treatment, on the surface by swabbing, and in the deeper parts of the wood by scraping, was used to test the efficiency of the disinfection. Our results indicate that chemical disinfection is only complete when high concentrations (> 50%) of the disinfectant are used. Heat treatment in general was found to be very effective. The scorching of wood was not satisfactory as it only killed spores at the surface. CONCLUSION Complete disinfection is only possible with some heat treatments or by using high concentrations of chemical disinfectants. SIGNIFICANCE AND IMPACT OF THE STUDY This study puts forward some methods that can provide complete decontamination, which is necessary for an effective control of American foulbrood disease.
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Abstract
The clinical and urodynamic findings in 1,193 consecutive women referred for investigation of urinary incontinence and other urinary symptoms were reviewed. Impaired bladder emptying was defined as a repeated maximum flow rate below 15 ml/second or a residual urine volume of 150 ml or more. One hundred and sixty-five women were diagnosed as having voiding dysfunction. Fifty-six of the 165 women (34%) had a residual urine volume of 150 ml or more. Voiding dysfunction was the only abnormal urodynamic finding in 27 women and was associated with genuine stress incontinence, detrusor instability or bladder hypersensitivity in a further 138 patients. Overflow incontinence was diagnosed in 7 women (0.5%). Symptoms of impaired bladder emptying were significantly more common in women with proven voiding dysfunction but were absent in a third of these patients. One in 4 women with normal micturition had symptoms of voiding difficulty. Neurological disease, pelvic surgery and psychological factors were important causes of voiding dysfunction. Voiding disorders are a common cause of lower urinary tract dysfunction and should be an important consideration in future patient management.
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Abstract
A study of 30 women who had polyhydramnios in more than 1 pregnancy revealed that 8 of the 36 resultant pregnancies (22.2%) were associated with diabetes mellitus, 14 (37.8%) with fetal macrosomia, and the perinatal mortality was 16.2% (6 of 37). The incidence of major fetal malformations or abnormalities was 18.9% (7 of 37); 4 of the 6 deaths resulted from malformations (anencephalus (2), hydrocephalus (1), nonimmune hydrops (1)), and the other 2 deaths were from hyaline membrane disease associated with prematurity. Recurrent polyhydramnios occurred in 1 in 1,720 pregnancies. The onset was acute in 3, subacute in 2 and chronic in 31, the perinatal deaths in these categories being 2, 1 and 3 respectively. The risk of recurrent polyhydramnios is the risk of fetal malformation and premature delivery. The latter may be preventable by prompt therapy with indomethacin, and serial amniocentesis if this therapy fails.
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Abstract
Over a 10-year period when 51,022 singleton infants were delivered, 19 pregnancies (1 in 2,685) were complicated by acute polyhydramnios 17 (1 in 3,000) by subacute polyhydramnios and 501 (1 in 102) by chronic polyhydramnios. The incidence of major congenital malformations in singleton pregnancies associated with acute polyhydramnios was 63% and the perinatal mortality rate was 74%. When subacute polyhydramnios occurred in singleton pregnancies, the incidence of major congenital malformations was 65%, similar to acute polyhydramnios, but the perinatal mortality rate was only 35%. The comparable figures for chronic polyhydramnios in singleton pregnancies were a major malformation incidence of 14% and perinatal mortality rate of 10%. The type of onset of polyhydramnios, acute, subacute or chronic is therefore the most important indicator of prognosis. In patients with gross polyhydramnios, acute renal failure must be specifically excluded.
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Abstract
This paper reports the experience with acute polyhydramnios complicating twin pregnancies at the Mercy Maternity Hospital for the 10-year and 2-month period from January, 1979 to February, 1989 during which time there were 13 such cases, an incidence of 1 in 4,044 pregnancies. Acute polyhydramnios complicated 1.7% of all twin pregnancies. The perinatal mortality rate was 88.5% and accounted for 16.7% of the perinatal deaths in twins. No major fetal malformations were found. One case of acute polyhydramnios was successfully managed with ultrasonographically guided serial amniocenteses. The management of this rare condition is considered.
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Abstract
New methods of ovulation induction have been discovered and perfected in recent years. Among others, gonadotrophin-releasing hormone (GnRH) agonists are being used increasingly in the treatment of ovulatory infertility. In a prospective study, 24 women undergoing artificial insemination with donor sperm (AID) and facing failure of treatment because of ovulation disorders, were treated with human menopausal gonadotrophin/human chorionic gonadotrophin (HMG/HCG) superovulation with or without pituitary densensitization using a superactive luteinizing hormone-releasing hormone (LHRH) agonist, buserelin (BUS), Suprefact (Hoechst, Frankfurt a/Main, FRG). In 86 cycles stimulated with HMG/HCG no pregnancy occurred, whereas 12 pregnancies occurred in the same group of patients after a total of 43 BUS/HMG/HCG stimulation cycles. Superactive LHRH agonists have a definite place in the treatment of AID patients presenting with refractory ovulation disorders and/or luteal insufficiency.
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Abstract
This paper reports the only 6 cases of ureteric obstruction apparently caused by the gravid uterus diagnosed at the Mercy Maternity Hospital in the past 17 years, during which time there were 82,836 confinements. In 3 of the 6 cases there was clear radiographic evidence that the level of obstruction was at the pelvic brim. The rapid resolution of the ureteric obstruction shortly after delivery strongly suggested that the gravid uterus was the cause of the obstruction. Cases 1-3 were the only patients of 793 with polyhydramnios who developed bilateral ureteric obstruction and acute renal failure. In Cases 4 and 5 there was unilateral ureteric obstruction and pyelonephritis; in Case 4 a ureteric catheter was inserted from below, and in Case 5 a ureteric stent was inserted via a nephrostomy tube. In Case 6 a percutaneous nephrostomy tube was inserted.
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Myomectomy during pregnancy: uncommon case report. Acta Chir Belg 1989; 89:212-4. [PMID: 2678853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of myomectomy during pregnancy is presented. Generally myomectomy is contraindicated during this period. On the 14th week of pregnancy our patient presented with progressive lower abdominal pain and a tender mass of nearly 12 centimeter diameter in the pouch of Douglas. Therefore an exploratory laparotomy was performed to exclude torsion of an adnexal mass or pedunculated subserous myoma. A dorsal degenerating myoma with short thick pedicle (4 cm diameter) was found. It was compressed between the promontory of the sacrum and the uterus. Myomectomy was performed and pregnancy progressed without complications.
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A lesson from IVF endocrinology: the importance of the follicular phase to success and failure in non-IVF cycles. ACTA EUROPAEA FERTILITATIS 1986; 17:251-8. [PMID: 3107301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Sixty-three patients treated with exogenous gonadotropins for a total of 232 non-IVF cycles were monitored by serum E2 and/or total urinary estrogen excretion. The endocrine profile of follicular phase during HMG-HCG stimulation was evaluated with regard to an effect on the pregnancy rate. Six different follicular phase patterns were observed: A-profiles (daily exponential increase of sE2 or total urinary estrogen values followed by a sustained exponential increase on the day after HCG injection) seem to be necessary to obtain pregnancy, being followed by conception in 21.5% of all cases. Other profiles have lower conception rate (10%); no conception occurred when non exponential E2 rise was observed. The different responses are not related to total dosage of HLG administered. Patients who were treated for hypogonadotropic hypogonadism had a high pregnancy rate (80%) even in absence of post-HCG estrogen rise (G-endocrine profiles. Women aged 35 years must have significantly higher doses of gonadotropins to obtain A-profiles. Monitoring by E2 seems to be more adequate than the TUE only (conceptual pregnancy rate/cycle of 15.25%, versus 10.34%). In conception cycle, midluteal E2/P ratio never exceeds 50.
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