RESUMEN
OBJECTIVE: Ultrasound examination plays a central role in case of suspected non-viable pregnancy. A wrong diagnosis might have major consequence in terms of inadequate care, especially in cases of false positive non-viable pregnancy diagnosis. Ultrasound criterions are today well defined. Our objective was to evaluate the feasibility and reproducibility of a novel image-quoting method of first-trimester non-viable pregnancy. METHODS: Thirty images of non-viable pregnancy were twice evaluated with blinded proofreading. Two quotations were evaluated: the first for the images of gestational sacs without embryo (gestational sac score), the second for the images with embryo (embryo score). RESULTS: The ICC (interclass correlation coefficient) was>0.75 for inter- and intra-observer reproducibility both for the quotations of the gestational sac and for the embryo with a low variability. Reproducibility of quoting crown rump length measurements <5mm was low at first proofreading but after adjustment of the quoting modalities, ICC was also>0.75. CONCLUSION: The inter- and intra-observer reproducibility of our quoting methods is high with a low variability. They might be a useful tool in current practice in the future.
Asunto(s)
Aborto Espontáneo/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Aborto Espontáneo/terapia , Largo Cráneo-Cadera , Errores Diagnósticos , Femenino , Edad Gestacional , Saco Gestacional/diagnóstico por imagen , Humanos , Variaciones Dependientes del Observador , Embarazo , Reproducibilidad de los ResultadosRESUMEN
Les auteurs rapportent une observation peu commune d'une complication de la fievre typhoide. Il s'agit d'un jeune homme de 18 ans; pecheur de son etat; hospitalise et traite dans un centre hospitalier peripherique de Brazzaville pour fievre typhoide confirmee par sero-diagnostic de FELIX et WIDAL. Sous traitement a base de Sulfamethoxazole-trimethoprime (Bactrim); il presente apres 8 jours de traitement medical un tableau d'abdomen aigu febrile. Il est transfere au CHU de Brazzaville ou il est opere apres reanimation. Il s'agissait d'une peritonite par perforation du collet de la vesicule biliaire non lithiasique
Asunto(s)
PeritonitisRESUMEN
The authors reviewed 34 cases of thyroid epithelioma registered in French Polynesia from 1985 to 1990. Annual incidence classifies French Polynesia as a region with low endemicity. The patients were 31 females and 3 males. In 18 cases, carcinoma was discovered within a multiheteronodular goitre (MHNG) and in 16 cases within an isolated nodule. In each of these sub-groups, 4 micropapilliform cancers discovered at the occasion of a histopathological test. The mean age of the patients carrying a noduliferous cancer is 36.5 years and the one of multiheteronodular goitre is 50. No particular risk factor was discovered. Mean age of the disease is 2.8 years as far as noduliferous cancers are concerned, and 8.5 years for multiheteronodular goitre. The anatomical and echographic characters are discussed. What demanded a surgery intervention is reviewed. Mortality during intervention is zero. Morbidity recorded 17% of unilateral recurrent paralysis and 50% of transitory parathyroid insufficiency. Extemporaneous anatomopathological test was contributing in 25% of the cases; definitive test revealed 25 (74%) papilliform cancers (of which 8 micropapilliforms) and 9 vesicular cancers (26%). No canceration anaplasia was discovered. Evolutive stage is precised: 7 local invasions (isthm and/or capsule), 4 bifocal localizations, 8 cancers with adenoid metastasis, 4 with osseous and/or pulmonary metastasis. The way to select a therapy is reported and discussed. Cost evaluation is suggested in order to discuss the possibility to acquire for the Territory an equipment for isotopic exams.