Background: To investigate the predictive value of ultrasound indicators in early pregnancy for the outcome of caesarean scar pregnancy (CSP) after pregnancy termination.
Methods: This study retrospectively analysed the ultrasound images of 98 CSP patients who underwent transabdominal ultrasound-guided hysteroscopic curettage during early pregnancy at Changsha Hospital for Maternal and Child Health Care between January 2017 and October 2021. Patients were equally divided into a case group and a control group. The case group included 49 CSP patients with postoperative complications, such as intraoperative blood loss ≥ 200 ml or retained products of conception (RPOC). The remaining 49 CSP patients, with similar age and gestational age and with good postoperative outcomes, such as intraoperative blood loss ≤ 50 ml and no RPOC, were included in the control group. CSP was classified into three types according to the location of the gestational sac (GS) relative to the uterine cavity line (UCL) and serosal contour. Differences in ultrasound indicators between the case and control group were compared.
Results: There were significant differences between the case and control groups in the mean gestational sac diameter (MGSD), residual myometrium thickness (RMT) between the GS and the bladder, blood flow around the GS at the site of the previous caesarean incision, and types of CSP (P < 0.05). The r of each ultrasound indicator were as follows: 0.258, -0.485, 0.369, 0.350. The optimal threshold for predicting good postoperative outcomes, such as intraoperative blood loss ≤ 50 ml and no RPOC, by receiver operating characteristic (ROC) curve analysis of the RMT was 2.3 mm.
Conclusion: Our findings show that the RMT, blood flow around the GS at the site of the previous caesarean incision, and types of CSP have a low correlation with postoperative complications, such as intraoperative blood loss ≥ 200 ml or RPOC, of early pregnancy termination in patients with CSP. To some extent, this study may be helpful for clinical prognostic prediction of patients with CSP and formulation of treatment strategies. Given the low correlation between these three indicators and postoperative complications, further studies are needed to identify indicators that can better reflect the postoperative outcomes of CSP patients.
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http://dx.doi.org/10.1186/s12884-023-06197-x | DOI Listing |
AIDS Res Ther
December 2024
Veterans Affairs (VA) Connecticut Healthcare System Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), 950 Campbell Avenue, West Haven, CT, 06516-2770, USA.
Background: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.
Methods: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights.
BMC Med Educ
December 2024
School of Public Health, Peking University, Beijing, China.
Introduction: Combination of Standardized Patient (SP) and Case Based Learning (CBL) is a common method in medical education, but traditional SP (TSP) may not be conducive to students' mastery of basic medical knowledge and the cultivation of clinical thinking. Therefore, it is necessary to innovate SP to optimize SP combined with CBL teaching method.
Objective: This study aims to explore the effectiveness of a chatbot utilizing standardized patients based on CBL (CSP-CBL) for colorectal cancer education.
Front Cardiovasc Med
December 2024
Cardiology Department, Aswan Heart Center, Aswan, Egypt.
Biventricular pacing (BiVP) has been the cornerstone of cardiac resynchronization therapy (CRT) in the management of symptomatic heart failure patients with reduced ejection fraction (HFrEF) and electrical dyssynchrony despite guideline-directed medical therapy (GDMT). However, BiVP has some limitations, including technical difficulties and high non-response rates. Conduction system pacing encompassing His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) has recently emerged as a promising alternative to CRT in this group of patients.
View Article and Find Full Text PDFExpert Rev Cardiovasc Ther
December 2024
School of Biomedical Engineering and Imaging Sciences, King's College London, UK.
Introduction: Cardiac Resynchronization Therapy (CRT) is an effective treatment for heart failure (HF) in approximately two-thirds of recipients, with a third remaining CRT 'non-responders.' There is an increasing body of evidence exploring the reasons behind non-response, as well as ways to preempt or counteract it.
Areas Covered: This review will examine the most recent evidence regarding optimizing outcomes from CRT, as well as explore whether traditional CRT indeed remains the best first-line therapy for electrical resynchronization in HF.
Front Physiol
December 2024
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
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