Agenesis of the appendix vermiformis represents a rare condition that accounts in approximately 1 in 100.000 laparotomies performed for suspected acute appendicitis. L.B., female, born at term after a normal pregnancy. Shortly after birth she presented respiratory distress; chest x-ray showed a left diaphragmatic hernia (CDH). At operation was noted ...

A 26-year-old woman presented with acute Budd-Chiari syndrome 18 weeks into a pregnancy. She was found to be heterozygous for the G20210A prothrombin gene mutation. She was treated with portacaval shunt placement and successfully completed the pregnancy, with a healthy baby delivered at 31 weeks' gestation. She developed progressive liver ...

OBJECTIVE: To investigate factors predictive of the outcome of acute respiratory failure during pregnancy. STUDY DESIGN: We retrospectively reviewed the records of all pregnant women diagnosed with acute respiratory failure at a tertiary referral center from January 1, 1995, to September 30, 2000. Maternal characteristics, etiology of respiratory failure and ...

OBJECTIVE: To evaluate pregnancy course, complications, and outcomes in liver transplant recipients. METHODS: We conducted a retrospective review of 38 pregnancies conceived between 1992 and 2002 in 29 women who underwent liver transplantation at Mount Sinai Medical Center. RESULTS: The most common primary liver disease was autoimmune hepatitis. All patients ...

The early inflammatory changes in the tympanic membrane were explored in 2 rat models. Acute otitis media was induced by instillation of Streptococcus pneumoniae type 3 into the middle ear cavity, and otitis media with effusion was induced by blockage of the eustachian tube. Otomicroscopic examination was performed before the ...

Lipoprotein apheresis is an effective treatment for severe disorders of lipid metabolism. It is the only life prolonging therapy for patients with homozygous familial hypercholesterolemia. Changes of lipid metabolism during pregnancy related to changes of hormone concentrations do not cause clinical complications in the majority of cases. However, in particular ...

Heat shock proteins (HSPs) are cytoprotective molecules that help to maintain the metabolic and structural integrity of cells. In this review, we briefly discuss the regulation and function of HSPs. The review focuses on the current knowledge of pancreatic HSP induction, the HSP level changes during acute pancreatitis, the potential ...

We studied immediate and delayed changes in ECG in female albino rats subjected to acute hypobaric hypoxia on days 4-5 of pregnancy and evaluated the possibility of correction of hypoxia-produced disturbances with some peptides. Acute hypoxia lengthened the mean RR interval, increased heart rate variability, and decreased the monotony index. ...

OBJECTIVES: To determine the anatomical location of the appendix, as it may change during pregnancy. METHODS: In this prospective study conducted from October 1995 to March 1999, 291 women of reproductive age were evaluated for appendix location. They were divided into three groups: group A, 165 women between 37 and ...

Lipid accumulation - in hepatoytes (both subclinically and in acute fatty liver of pregnancy), in the endothelium of placental vessels ("acute atherosis"), and in the bloodstream - has been well established to be a consequence of preeclampsia. Hyperlipidemia (specifically hypertriglyceridemia) has been demonstrated to be a risk factor for the ...

The incidence of acute leukemia in pregnancy is low and the management of acute leukemia during pregnancy is difficult. We have observed a total of 10 pregnancies in 8 patients. Six of the patients had acute myeloblastic leukemia (AML) and two of them had acute lymphoblastic leukemia (ALL). Three of ...

Imatinib (Gleevec) (formerly STI571) has demonstrated high levels of efficacy in chronic myelogenous leukemia (CML) and gastrointestinal stromal tumors (GIST) and has been used in more than 12,000 patients participating in clinical trials. Experience from clinical trials with imatinib has largely demonstrated the drug to be well tolerated in humans. ...

We describe two cases of intracoronary vascular brachytherapy where bivalirudin (Angiomax), employed as an anticoagulant, led to abrupt vessel closure or threatened abrupt closure. Use of bivalirudin (Angiomax) during intracoronary brachytherapy may predispose to the formation of intracoronary thrombus, related to the reversible binding kinetics of the bivalirudin to thrombin, ...

BACKGROUND: Gallbladder torsion is rarely diagnosed in pregnancy, but prompt surgical intervention is necessary to avoid possible sepsis and death. CASE: A 28-year-old, African American woman at 30(6/7) weeks' gestation was admitted with the presumed diagnosis of acute cholecystitis. The patient was treated conservatively. However, on re-examination, the patient's physical ...

OBJECTIVES: There are few data in the literature regarding the indications, therapy, and safety of endoscopic management of pancreatico-biliary disorders during pregnancy. We report the largest single center experience with ERCP in pregnancy. METHODS: We reviewed 15 patients that underwent ERCP during pregnancy. In all patients, the pelvis was lead-shielded ...

OBJECTIVE: We reviewed evidence suggesting teratogenic risk associated with the use of antidotes in the acute management of poisoned pregnant women. METHODS: Medline, Toxline, and DART/ETIC searches; references of retrieved articles, pertinent databases and textbooks were also searched. RESULTS: There are case reports or case series of women who received ...

We tested the hypothesis that enhanced nitric oxide (NO) opposes fetal peripheral vasoconstrictor responses to acute hypoxaemia via actions involving the carotid chemoreflex and the adrenal medulla. The hypothesis was tested in the late gestation ovine fetus using a novel NO clamp technique, which involves fetal combined treatment with the ...

Since leukocystosis and anemia are common findings in pregnancy, pathological alterations in hematopoesis, such as leukemias, can sometimes proceed undetected. Chemotherapy during pregnancy carries the risk of teratogenic effects on the fetus, and there is little data to guide chemotherapeutic regimens for leukemia during pregnancy. The following paper describes our ...

BACKGROUND: Pancreatic sphincter hypertension increases the risk of pancreatitis in patients undergoing ERCP. Glyceryl trinitrate reduces sphincter of Oddi pressure. This study tested the hypothesis that transdermal glyceryl trinitrate could be effective in the prevention of post-ERCP pancreatitis. METHODS: One hundred forty-four patients undergoing ERCP were randomized: 71 received a ...

Cryptococcus antarcticus Vishniac & Kurtzman var. circumpolaris Vishniac and Onofri var. nov. (Filobasidiales, Tremellomycetidae, Hymenomycetes), an anamorphic yeast with ca. 73% nDNA relatedness to Cryptococcus antarcticus var. antarcticus, differs in failure to assimilate raffinose, a lower maximum temperature for growth, fatty acid profile, and in a single nucleotide change in ...

We report that a 27-year-old woman with bilateral severe hydronephorosis during pregnancy 20 years after antireflux surgery. The patient developed postrenal acute renal failure due to obstruction of the lower ureter. This patient could safely give birth after bilateral percutaneous nephrostomy through joint management with the obstetrics and gynecology staff. ...

OBJECTIVE: To evaluate the significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy. SAMPLE: Of the 40,112 women delivering at our institution (January 1995 to June 2002), 38 women (0.094%) were operated due to the suspicion of appendicitis during pregnancy. METHODS: Body temperature, clinical examination, ...

We examined a newborn who had no bile and pancreatic ducts. Hydrops was evident after 29 weeks of gestation and she died shortly after birth, weighing 1,368 g. One of her siblings had died of hydrops at about six months of gestation, and there were two more miscarriages of unknown ...

A patient aged 42, diagnosed with polycondritis for approximately 14 years is presented; she has undergone urgent surgery for a splenic abscess in imminent fistulization in the left pleural cavity. Her susceptibility to infections is marked in time by surgical interventions for pultaceous amygdalitis, an abscess of the right submandibular ...

Liver dysfunction in pregnancy has serious consequences. Its frequency and characteristics have not been systematically documented in Britain. We have prospectively determined incidence, causes, and outcome of liver dysfunction in pregnancy in an obstetric unit in Southwest Wales, UK. A central laboratory identified all abnormal liver tests (bilirubin >25 micro ...

A first-trimester primigravid patient presented with hyperemesis and malaise. Work-up was consistent with primary hyperparathryoidism. During acute treatment, she developed generalized motor seizures considered to be secondary to hypercalcemia. Evaluation and treatment of women with primary hyperparathyroidism and hypercalcemia are reviewed, and the pathogenesis of seizures associated with hypercalcemia is ...

BACKGROUND: A viable intrauterine pregnancy with salpingitis has been reported rarely. CASE: A 27-year-old woman at 10 weeks' gestation developed abdominal pain, fever, leukocytosis, peritoneal signs, closed cervix and a viable pregnancy. Progression from acute salpingitis to septic abortion was documented. CONCLUSION: Acute salpingitis in the presence of a viable ...

Acute fatty liver of pregnancy is an uncommon, potentially fatal disorder. Between 1998 and 2000, two patients with acute fatty liver of pregnancy presented at the Christian Medical College Hospital, Vellore. Both patients were in the thirty-sixth week of pregnancy. jaundice and encephalopathy were the predominant symptoms. Both the mothers ...

Human monocytic ehrlichiosis (HME) is caused by Ehrlichia chaffeensis, an obligate intracellular bacterium that infects mononuclear phagocytic cells. We report a unique case of HME diagnosed in a woman who presented with abdominal pain and acute appendicitis during early pregnancy and whose condition progressively deteriorated to adult respiratory distress syndrome.

A case is reported of a pregnant 16-year-old-woman diagnosed with Acute promyelocytic leukaemia (APL) at 25 weeks gestation and treated with all-trans retinoic acid (ATRA) (45 mg/m2) for 25 days in combination with chemotherapy. She achieved a complete cytogenetic and molecular remission. Clinical course was complicated, with an intracerebral bleed, ...

When confronted with liver abnormalities during the third trimester of pregnancy, one should consider acute fatty liver of pregnancy. The differential diagnosis with (pre-)eclampsia and HELLP syndrome is sometimes difficult. In these cases a liver biopsy is helpful though rarely performed during pregnancy. After delivery of the child the liver ...

Acute bronchoconstriction after isocapnic hyperpnea can be produced in most asthmatic individuals. However, the existence of a late-phase response is less certain. We used a canine model of isocapnic hyperpnea to test the hypothesis that this discrepancy is due to differences in the challenge threshold for the responses. Acute-phase and ...

Since the first report of long-chain L-3-hydroxyacyl-coenzyme A dehydrogenase deficiency a little more than a decade ago, its phenotypic and genotypic heterogeneity in individuals homozygous for the enzyme defect has become more and more evident. Even more interesting is its association with pregnancy-specific disorders, including preeclampsia, HELLP syndrome (hemolysis, elevated ...

BACKGROUND: Acute fatty liver of pregnancy is a rare entity. A MEDLINE English-language search from 1966 to the present revealed no reports of acetaminophen toxicity and acute fatty liver in pregnancy. CASE: An 18-year-old, African American woman, gravida 1, presented at 33 weeks' gestation with signs and symptoms consistent with ...

The amount of emboli formed (percentage of total emboli area to the right atrial area [%Ae]) after tourniquet release in invasive procedures of the medullary cavity is empirically much larger than that in noninvasive procedures, even if the tourniquet duration is similar. Thus, we compared %Ae between arthroscopic reconstruction of ...

Acute intermittent porphyria (AIP) is an inherited disorder characterized by partial defects in the heme biosynthetic pathway. Although its association with pregnancy is rare, it presents the obstetrician with challenging problems especially in labor management, as one of the obstetrical life line drugs (methergin) is contraindicated for use in these ...

Puerperal psychoses do not represent a nosological entity, but rather a selection of puerperally triggered "ordinary" functional psychoses with cycloid psychoses predominating and schizophrenias occurring very rarely. The prognosis is basically favorable concerning symptom remission and social and occupational functioning. However, there is a considerable frequency of relapses and an ...

Acute liver disease in pregnancy may have fatal consequences. Pre-eclampsia, HELLP syndrome and acute fatty liver of pregnancy form a spectrum of disease that range from mild symptoms to severe life-threatening multi-organ dysfunction. Early recognition of signs and prognostic indicators may enable prompt referral to specialist centres providing the multidisciplinary ...

The third trimester of pregnancy has several unique disease entities that challenge the anesthetist. Acute fatty liver of pregnancy (AFLP) is an increasingly recognized metabolic disorder found late in pregnancy. Current research estimates the incidence of AFLP at 1 per 6,659 births. Improved maternal morbidity and mortality is credited to ...

Acute fatty liver of pregnancy (AFLP) is a rare and dreaded complication of pregnancy, almost exclusively seen in the third trimester. The histopathologic features of AFLP closely resemble those seen in metabolic disorders characterized by deficiency of fatty acid oxidative enzymes. Several reports have established a strong association between AFLP ...

BACKGROUND: Embryonal sarcoma of the liver is a rare undifferentiated mesenchymal neoplasm with a grave prognosis. CASE: We report a spontaneous uneventful pregnancy in a young woman with recurrent metastatic embryonal sarcoma of the liver after hepatectomy (twice) and radiochemotherapy. The patient chose to continue pregnancy despite her general condition ...

Although acute and chronic treatment with nicotine impairs nitric oxide synthase-dependent responses of large and small blood vessels, the effect of nicotine on other vasodilator pathways remains uncertain. The goal of the current study was to determine effects of nicotine on dilatation of arterioles to activation of ATP-sensitive potassium channels. ...

Reported causes of pancreatitis in pregnancy include: gallstone disease, hyperlipidemia, alcohol ingestion, viral, and idiopathic. Few reports associate pancreatitis with pregnancy-induced hypertension. A 35-year-old women with pregnancy-induced hypertension and spontaneous rupture of membranes was admitted for induction of labor. Her postpartum course was complicated by acute renal failure that responded ...

BACKGROUND: Acute appendicitis during pregnancy is a serious complication because of the difficult diagnosis and increased perinatal morbidity and mortality. CASE: A 29-year-old woman underwent cesarean section and an appendectomy because of clinical symptoms of an acute abdomen and fetal distress. CONCLUSION: Acute appendicitis in pregnancy is rare but requires ...

Interpretative phenomenological analysis (IPA) was used to analyse data from one man whose partner underwent a third-trimester termination of pregnancy for foetal abnormality. This case study examines the data from the participant and aspects of grief are examined qualitatively from a male perspective. The importance of the male role, management ...

PURPOSE: A case of acute pancreatitis with severe hypertriglyceridemia occurred following use of intramuscular estradiol valerate during endometrial preparation for cryopreserved embryos. METHODS: A 30-year-old woman with primary infertility and a past history of well-controlled hypothyroidism, underwent endometrial development with intramuscular estradiol valerate in preparation for the transfer of cryopreservred ...

Three patients with chronic myeloid leukemia (CML) in chronic phase received interferon-alpha during pregnancy, starting from the 1st trimester. No maternal complications were reported. The 3 patients delivered normal looking babies apart from one baby who was found to have transient mild thrombocytopenia. Subsequently these children were followed for 30, ...

Mercury vapor is known penetrate the placental barrier more easily than inorganic mercury. A relative amount of mercury accumulates in the fetus after exposure of pregnant animals to mercury vapor. Mercury concentration in fetal organs is much lower than that in maternal organs except the liver, and fetal liver shows ...

Maternal death from HELLP syndrome, a complication of (pre-) eclampsia during pregnancy or postpartum, is rarely encountered in forensic pathology. We report three cases of HELLP syndrome with fatal outcome putting the main focus on the histopathological features of the disease. We found an almost identical histopathological pattern in the ...

BACKGROUND/AIM: While the characteristics of ascites in the setting of chronic pancreatitis are well established, little has been written about the characteristics of spontaneous, clinically apparent ascites in the setting of acute pancreatitis. Our aim was to define the characteristics of clinically apparent ascites complicating acute pancreatitis, particularly with regard ...