Casa di Cura Abano Terme Polispecialistica e Termale SpA

How do clinical rectovaginal examination and transvaginal ultrasound examination perform in the diagnosis of parametrial infiltration in patients with endometriosis?

This was a multicentre prospective observational study. Patients with suspected deep endometriosis at clinical examination and/or at ultrasound evaluation and scheduled for surgery were included. Following multicentre multidisciplinary meetings, consensus was obtained on terms and methodology to define the parametrium at pelvic anatomy, ultrasound and surgery. Sensitivity, specificity, accuracy, and positive and negative likelihood ratios were calculated for clinical and ultrasound examinations with respect to surgery.

In total, 195 women were selected for the present study and 164 were included in the analysis. Ultrasound examination had good to high specificity (>80%) for all parameters, except the left lateral parametrium (78.8%). The sensitivity of ultrasound examination was good to high for fixity of the right and left ovaries, uterosacral ligaments, retrocervix and rectovaginal space; and low for the anterior and lateral parametria, vagina, bladder and bowel. Clinical examination had good to high specificity for fixity of the left ovary, anterior parametrium, right uterosacral ligament, retrocervix and vagina; and low specificity for fixity of the right ovary, lateral parametrium, left uterosacral ligament and rectovaginal space. The sensitivity of clinical examination was good for the uterosacral ligaments and rectovaginal space, and low for the remaining parameters.

Ultrasound examination provided good specificity for all the parameters, but sensitivity was low for the anterior and lateral parametria. Clinical examination provided good specificity for the anterior and posterior parametria, but sensitivity was low for the anterior and lateral parametria. Further prospective studies are needed to validate this methodology and confirm the results.

This study was aimed to evaluate the feasibility, safety, and advantages of the use of transurethral intraprostatic anesthesia (TUIA) using Schelin Catheter^TM (SC) in patients undergoing holmium laser enucleation of the prostate (HoLEP).

TUIA was performed using SC, a catheter equipped with an operative channel with a retractile needle, a standard drainage outlet, and a balloon port. After inserting the SC into the patient's urethra and filling the balloon to anchor it in the bladder neck, four target injections with local anesthetic were performed, one in each quadrant in the base area of the prostate. After injections, the catheter was removed and the HoLEP procedure started. During the procedure, patients also received moderate sedation/analgesia.

We selected two 63-year-old patients with good performance status. Prostate volume was 40 ml for the first patient and 31 ml for the second. TUIA and HoLEP operative times were 68 minutes in the first patient and 42 minutes in the second.During the procedure, patients complained of only minimal discomfort, and during hospitalization patients' numeric rating scale (NRS) pain score ranging from 1 to 0, with no need for additional analgesics. No complications were reported perioperatively and 15 days after the procedure.

This is the first report on TUIA via SC in patients undergoing HoLEP. In our preliminary experience, TUIA via SC was safe and feasible, showing complete perioperative pain control. Further studies are needed to confirm these promising results and better define the category of patients eligible for this type of treatment.

The consumption of raw seafood, generally considered to be a healthy food, has greatly increased worldwide. Pathogens of fish can cause foodborne illnesses in humans, especially following the consumption of raw seafood from contaminated water.Foodborne illness in pregnant women is seldom the cause of neonatal infection, but, as in the reported cases, it has been associated with a high degree of morbidity and mortality.We present the case of a newborn with septicemia and meningitis caused by Plesiomonas shigelloides acquired via the transplacental route. There was a maternal history of ingestion of raw seafood 1 week prior to delivery. A few similar cases are described in the existing literature, which reports 7 neonatal deaths.Therefore, the primary objective of this paper is to highlight the fact that the popularity of raw seafood such as sushi, sashimi, and oysters, requires an improvement in dietary advice regarding unsafe choices in pregnancy in order to avoid preventable foodborne diseases, sometimes fatal for the newborn.