Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

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Volume 2, Issue 3, May 2013

  • Authors: Gustavo Romero-Gutiérrez, Antonio Abraham Huebe-Martínez, Immer Amaral-Navarro, Armando Saúl Ruiz-Treviño

    Abstract: Objective: To determine which variables obtained by Doppler ultrasound are associated with the outcome of patients with threatened abortion. Study design: We carried out a cross-sectional study. The patient population included patients with pregnancy less than 20 weeks, who were hospitalized with the diagnosis of threatened abortion. Results: We followed the outcome of 223 patients and found 32 patients (14.3%) who aborted and 191 patients (85.7%) who did not abort. The fetal heart rate for the group who aborted was significantly lower than the group who did not abort (143 ± 2.9 vs. 154 ± 3.6 beats per minute, respectively), p = 0.002; the resistance index of uterine artery was higher (0.79 ± 0.07 vs. 0.76 ± 0.09, respectively), p = 0.018; and the resistance index of trophoblastic flow was higher (0.55 ± 0.04 vs. 0.50 ± 0.06, respectively), p = 0.041. The resistance index of umbilical artery and corpus luteum were not statistically different. Conclusion: Alterations of fetal heart rate, resistance index of uterine artery and trophoblastic flow are associated with adverse outcome in women with threatened abortion.

    Received: Apr. 10, 2013 Accepted: Published: May 2, 2013

    DOI: 10.11648/j.cmr.20130203.11 View: Downloads:

  • Authors: Nezahat Gurler, Lutfiye Oksuz, Bahar Yuksel, Recep Has

    Abstract: Although not common, postpartum and post-abortion infections caused by clostridia can be severe. Clostridial uterine infections start as localized chorioamnionitis as a result of an infection from the fetus and/or placental tissues. The infection may spread to the uterine wall and endometrial tissues, and, in the most severe cases, uterine necrosis accompanied by sepsis ensues. In this paper we report the presence of Clostridium perfringens isolated from blood culture and placental specimen after the termination of a 29 gestational week pregnancy. The woman had a history of having omphaloceled fetus and premature membrane rupture. Fetal omphalocele is a congenital defect of the abdominal wall that allows some of the abdominal organs to protrude through it. In order to find the focus of infection, blood and plasental specimen of the patient were examined. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventionally and confirmed by the automatized API 20A system. Antibiotic susceptibility testing was performed by E-test according to the recommendations of Clinical Laboratory and Standards Institute (CLSI). Although Clostridium spp is rarely isolated from blood cultures, anaerobically evaluation of blood cultures in the infections of abdominal and genital sites could be life-saving, as in this report.

    Received: Apr. 8, 2013 Accepted: Published: May 30, 2013

    DOI: 10.11648/j.cmr.20130203.12 View: Downloads:

  • Authors: Aris Lacis, Inguna Lubaua, Valts Ozolins, Eriks Jekabsons, Andis Lacis, Mara Ratniece, Andrejs Erglis

    Abstract: Pulmonary arterial hypertension (APAH, IPAH) is a devastating, progressive disease with increasingly debilitating symptoms [1,2].Intrapulmonary delivery of autologous stem cells could be beneficial for pathogenetic treatment for patients with severe pulmonary arterial hypertension.Two patients with severe pulmonary artery hypertension received intrapulmonary autologous mesenchymal (mononuclear) stem cell transplantation and stem cell transplantation in pulmonary arteries. Patients were examined by scintigraphy of lungs during the periods 12, 14 and 27 months after stem cell transplantation. We find out that perfusion in all lung segments were improved after 14 and 27 months.

    Received: Apr. 28, 2013 Accepted: Published: May 30, 2013

    DOI: 10.11648/j.cmr.20130203.13 View: Downloads:

  • Authors: Lutfiye Oksuz, Nezahat Gurler

    Abstract: Vibrio alginolyticus occasionally causes life-threatening infections in immunocompromised individuals. Bacteremia and necrotising fasciits caused by V.alginolyticus have been reported. We described a case of sepsis due to V. alginolyticus isolated from catheter of 19-year-old patient with hypercholesterolemy. Moreover the cases of invasive V.alginolyticus reported in the literature were reviewed. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventional methods and confirmed by the automatized ID32GN and VITEK 2 automation systems. Antibiotic susceptibility tests were performed according to recommendations of Clinical Laboratory and Standards Institute (CLSI). The patient recovered due to early diagnosis and appropriate therapy. No identifiable source of this infection could be determined. In conclusion, rapid and correct identification of the bacteria and early administration of appropriate antibiotics is essential for controlling invasive Vibrio infections, such as V.alginolyticus sepsis, especially in immunocompromised hosts. To the best of our knowledge, this is the first report of V.alginolyticus bacteremia in Turkey.

    Received: Apr. 9, 2013 Accepted: Published: May 30, 2013

    DOI: 10.11648/j.cmr.20130203.14 View: Downloads:

  • Author: Michael D Innis

    Abstract: Background: The Shaken Baby Syndrome conceived by Guthkeltch to explain bruises, fractures, retinal and cerebral haemorrhage and encephalopathy in children, called the “triad”, can be explained by an autoimmune reaction to antigens in a genetically susceptible child. Method: Children diagnosed as suffering from Non-accidental injuries were investigated for evidence of immune response reactions following mandated vaccination and childhood illnesses. Results: It was found in all the cases reported here the response to antigenic stimulation damaged the Beta cells in the Pancreas causing Hypoinsulinaemia which inhibited the cellular uptake of Vitamin C resulting in liver dysfunction, failure of carboxylation of the Vitamin K dependent proteins resulting in haemorrhages and fractures associated with the “triad”. Conclusion: Fractures, retinal and subdural haemorrhages and encephalopathy in children – is an autoimmune response to antigenic stimulation in a genetically susceptible individual. Common antigens are the mandated vaccines, viral bacterial and parasitic infections.

    Received: May 12, 2013 Accepted: Published: Jun. 10, 2013

    DOI: 10.11648/j.cmr.20130203.15 View: Downloads:

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