Audit of a fetal central monitoring station in a clinical setting.

Objective: To conduct an audit of the Omniview-SisPorto® central monitoring station (CMS) and determine the effect of the measures undertaken to correct identified problems.

Methods: All cardiotocograms (CTGs) recorded in randomly selected days of 2006 and 2009, both in the outpatient clinic and labor ward, were reviewed to assess the following parameters: tracing identification, duration, signal quality, signal loss, acquisition method, and time elapsed between tracing-end and birth. A random sample of cases was compared with original paper recordings and 25% of CTGs were re-retrieved for comparison with first retrieval.

Uterine compression sutures for postpartum hemorrhage: is routine postoperative cavity evaluation needed?

Postpartum hemorrhage due to uterine atony continues to be one of the major causes of maternal morbidity and mortality. Several uterine compression suture techniques have been described and are increasingly being used worldwide as a conservative approach. However, little is known about the long-term effects on the uterine cavity, as well as fertility and pregnancy outcomes.

Segmental neurofibromatosis: a rare variant of a common genodermatosis.

Segmental neurofibromatosis is a rare disorder characterized by features of neurofibromatosis type 1 circumscribed to a particular body segment. This entity is considered to be the result of a somatic mosaicism and is still under-diagnosed. We report a case of segmental neurofibromatosis and give a brief and up-to-date overview of the disease.

Tocilizumab - a new step in rheumatoid arthritis treatment.

Rheumatoid Arthritis is a chronic systemic inflammatory disease characterized by joint pain, stiffness and swelling, with progressive destruction of small joints of the hands and feet. Methotrexate remains the most commonly used therapy and has been the recommended standard against which new drugs should be evaluated and, to date, there is limited evidence that monotherapy with other treatments is superior to MTX. The introduction of biologic agents, such as TNFα-antagonists, represented an advance in the treatment of RA.

Vascular endothelial growth factor (VEGF) and prostate pathology.

Purpose: Previous studies suggest that vascular endothelial growth factor (VEGF) circulating levels might improve identification of patients with prostate cancer but results are conflicting. Our aim was to compare serum VEGF levels across different prostate pathologies (including benign prostatic hyperplasia, prostatitis, high grade prostate intraepithelial neoplasia and prostate cancer) in patients at high risk of prostate cancer.

Materials And Methods: We consecutively enrolled 186 subjects with abnormal digital rectal examination and/or total PSA (tPSA) > or = 2.

Twenty-five years after the FIGO guidelines for the use of fetal monitoring: time for a simplified approach?

Twenty-five years after the FIGO Workshop that produced the "Guidelines for the use of fetal monitoring," these remain the only broad international consensus effort in this field. Documents of a similar nature have been produced by national institutions, with subsequent updates of the initial concepts. The 3-class classification system has now been adopted by all the major guidelines, and while there are numerous similar features, and indeed many ideas were inspired by the FIGO guidelines, many key aspects still lack consensus.

The persistent challenge of foetal heart rate monitoring.

Purpose Of Review: To analyse the reasons why foetal heart rate (FHR) monitoring failed to fulfil the initial expectations of unequivocally decreasing perinatal morbidity and mortality, and to summarize the most recent advances in this field.

Recent Findings: It is now clear that expectations towards FHR monitoring at the time of its introduction into clinical practice were unrealistic. Several pitfalls in FHR monitoring have been identified, and solutions established to avoid them.

Skin adhesive versus subcuticular suture for perineal skin repair after episiotomy--a randomized controlled trial.

Objective: Surgical repair of perineal lesions after delivery is frequently associated with pain and discomfort, interfering with the normal activities of the puerperium. The aim of this study was to compare perineal skin repair after episiotomy with adhesive glue versus a subcuticular suture, regarding the incidence of pain and wound complications.

Study Design: Randomized clinical trial.

Kissing ulcer of the aortic wall in a patient with aortic valve endocarditis.

In patients with aortic valve endocarditis, lesion of the mitral valve leaflets caused by jet strike or vegetation touch (kissing) is a well-described complication. We present a case of infectious aortic ulcer caused by aortic valve vegetation kissing. A 72-year-old woman who underwent operation for Streptococcus viridans aortic valve endocarditis presented with a "kissing ulcer" in the aortic wall disclosed by intraoperative transesophageal echocardiography.

Pseudo-pericardial tamponade after cardiac surgery.

Cardiac tamponade is a common cause of hypotension and low output after cardiac surgery. The authors present a case of false tamponade diagnosis on transesophageal echocardiography in a patient who underwent mitral valve replacement and coronary artery bypass grafting. The diagnosis was not confirmed at surgery, and the cause of the abnormal right atrial filling was a prominent Eustachian valve trapped in the suture for correction of an iatrogenic inferior vena cava laceration.

Real-time PCR assays for high-throughput blood group genotyping.

There are multiple situations in the context of transfusion medicine where the classic serologic methods are unable to provide an adequate response, for example, recently polytransfused patients, patients with positive direct human antiglobulin tests, and hemolytic disease of the newborn. The traditional polymerase chain reaction techniques are slow and sometimes difficult to carry out and interpret. Thus there is a need for the development and validation of rapid and effective molecular methods.

Coronary artery spasm following aortic valve replacement.

The authors present a clinical case of coronary artery spasm in a 62-year-old woman undergoing elective aortic valve replacement surgery for aortic regurgitation. On admission at ICU, the patient developed marked hemodynamic and electrical instability. Emergent coronary angiography demonstrated a pronounced spasm of the distal portion of the right coronary artery, apparently related to compression of this vessel by a chest drain tube.

Stuck leaflet of bileaflet prosthesis in mitral position - five cases to make us think.

Objectives: We present five cases of mitral bileaflet prosthesis dysfunction as a result of a stuck leaflet in closed position, diagnosed at surgery or during the first postoperative year.

Methods And Results: The diagnosis was made by echocardiography and could be confirmed by fluoroscopy in three patients. All cases had in common an early occurrence and the presence of a clean prosthesis by transesophageal echocardiography (TEE).

Bilateral perisylvian polymicrogyria and chromosome 1 anomaly.

Polymalformative syndromes are always a clinical challenge for their complexity and sometimes for their rarity. Authors present the case of a girl with peculiar facies, macrocephaly, axial hypotonia, and severe development delay. Cerebral magnetic resonance showed polymicrogyria.

Body composition assessed by impedance changes very early with declining renal graft function.

Background: Kidney transplant (Tx) restores renal filtration, although it does not achieve the function of two native kidneys, and with time it may variably involute back to chronic renal failure. We hypothesized that bioelectrical impedance analysis (BIA) might highlight differences for body compartments among Tx with different filtration rates, and we compared them with healthy controls.

Methods: 38 Tx patients (25 males, 13 females) were studied at 75.

Nutritional status and body composition evolution in early post-renal transplantation: is there a female advantage?

Objective: Chronic renal failure is associated with metabolic derangements, affecting proteins, amino acids, and lipids. Usually these patients follow a restricted diet. Kidney transplant patients enjoy a recovery of renal function, but their therapeutics may entail significant changes in general metabolism.

Identification of XLRS1 gene mutation (608C > T) in a Portuguese family with juvenile retinoschisis.

Purpose: To characterize electroretinogram (ERG) and molecular genetic findings in a family with XLRS1 mutation. The authors present two cases of a Portuguese family with juvenile retinoschisis with a mutation in exon 6.

Methods: Two brothers and their parents, grandmother, and uncle underwent a full ophthalmic examination.

Identification of XLRS1 gene mutation (608C>T) in a Portuguese family with juvenile retinoschisis.

Purpose: To characterize electroretinogram (ERG) and molecular genetic findings in a family with XLRS1 mutation. The authors present two cases of a Portuguese family with juvenile retinoschisis with a mutation in exon 6.

Methods: Two brothers and their parents, grandmother, and uncle underwent a full ophthalmic examination.

Sequential body composition analysis by bioimpedance early post-kidney transplantation.

Background: While chronic renal failure patients present disturbed body water composition, few studies have been done on its behavior following kidney grafting (Tx). We report the changes associated with a successful Tx on body composition evaluated by bioelectrical impedance analysis (BIA).

Methods: Twelve Tx (seven males, five females) were studied.

Congenital dacryocystocele with intranasal extension.

Purpose: Congenital dacryocystocele is a rare anomaly in the newborn child. The swelling of lachrymal sac is observed by birth and it is associated with obstruction of lachrymal system either above or below lachrymal sac.

Methods: Diagnosis was made by clinical observation.

Choosing observers for evaluation of aesthetic results in breast cancer conservative treatment.

Purpose: The subjective evaluation of aesthetic results in conservative breast cancer treatment has largely been used without questioning the observer's skills. The aim of this study was to evaluate interobserver agreement of the aesthetic results of breast cancer conservative treatment in three groups of observers with different levels of experience.

Methods And Materials: Photographs were taken of 55 women who had undergone conservative unilateral breast cancer treatment and 5 control women with no breast disease.