Abnormal Fluid Collections Research Articles

To Study the Combined Use of Pleural Fluid Lymphocyte / Neutrophil Ratio and ADA for the Diagnosis of Tuberculous Pleural Effusion

INTRODUCTION - Pleural effusion is the abnormal collection of fluid in the pleural space. It is classified into exudates and transudates based on Light's criteria. Among the extra pulmonary presentations after tuberculous lymphadenitis, pleural TB is the second frequent. Although many biochemical parameters, such as lactate dehydrogenase (LDH), C-reactive protein (CRP), adenosine deaminase (ADA), interferon-gamma, and procalcitonin levels have been studied in the context of the diagnosis of exudative pleural effusion, its diagnosis is still challenging. AIMS & OBJECTIVES- To determine whether the combined use of ADA activity and lymphocyte/neutrophil ratio would provide a more efficient means for diagnosing tuberculous pleural effusion than the use of ADA alone. MATERIAL & METHODS- Hospital based Observational study was conducted over 8 months with total number of 100 Patients diagnosed as having pleural effusion based on clinical features and chest radiography in GEMS MEDICAL COLLEGE AND HOSPITAL. Biochemical, cytological and microbiology studies were done by obtaining pleural fluid by thoracocentesis. RESULTS - out of 100 cases, 84 cases were tubercular and had high level of ADA in comparison to rest of 16 non tubercular cases. At level of 50 IU/L of ADA activity test had sensitivity of 97.6%, specificity 87.5% which was increased to 100% and 92.8% in combination with test of Lymphocytic/Neutrophilic ratio - 0.75 CONCLUSION- The combined use of ADA along with the L/N ratio would provide a more efficient means for diagnosing tuberculous pleural effusion than the use of ADA alone.

Maternal "mirror" syndrome: Evaluating the benefits of fetal therapy.

To evaluate maternal and perinatal outcomes following fetal intervention in the context of maternal "mirror" syndrome. A multicenter retrospective study of all cases of fetal hydrops complicated by maternal "mirror" syndrome and treated by any form of fetal therapy between 1995 and 2022. Medical records and ultrasound images of all cases were reviewed. "Mirror" syndrome was defined as fetal hydrops and/or placentomegaly associated with the maternal development of pronounced edema, with or without pre-eclampsia. Fetal hydrops was defined as the presence of abnormal fluid collections in ≥2 body cavities. Twenty-one pregnancies met the inclusion criteria. Causes of fetal hydrops and/or placentomegaly included fetal lung lesions (n=9), twin-twin transfusion syndrome (n=6), severe fetal anemia (n=4), and others (n=2). Mean gestational age at "mirror" presentation was 27.0±3.8weeks. Maternal "mirror" syndrome was identified following fetal therapeutic intervention in 14 cases (66.6%). "Mirror" symptoms resolved or significantly improved before delivery in 8 (38.1%) cases with a mean interval from fetal intervention to maternal recovery of 13.1days (range 4-35). Three women needed to be delivered because of worsening "mirror" syndrome. Of the 21 pregnancies treated (27 fetuses), there were 15 (55.5%) livebirths, 7 (25.9%) neonatal deaths and 5 (18.5%) intra-uterine deaths. Following successful treatment and resolution of fetal hydrops, maternal "mirror" syndrome can improve or sometimes completely resolve before delivery. Furthermore, the recognition that "mirror" syndrome may arise only after fetal intervention necessitates hightened patient maternal surveillance in cases of fetal hydrops.

(O-24) EFFICACY OF ASPIRATION AND SCLEROTHERAPY FOR HYDROCELE: A SYSTEMATIC REVIEW

Abstract Introduction and Objetives Hydroceles are abnormal collection of fluid between the parietal and visceral layers of the tunica vaginalis. Traditionally, surgical excision and or repair under general anaesthesia has been the standard of care, but sclerosant therapy can be used safely and with efficacy for hydrocele’s treatment. This study aims to review and elucidate the current literature sclerotherapy for hydrocele. Methods We searched for articles in Pubmed, Embase and Cochrane evaluating aspiration and sclerotherapy for hydrocele treatment. Search terms were “hydrocele” and “sclerotherapy”. Relevant papers references were full reviewed searching for new articles. The sclerosing agents considered eligle were phenol, tetracycline, sodium tetradecyl sulfate, phenol and alcohol. Results We included 1554 patients from 26 studies. Mean aspirative hydrocele volume was 238,3 mL. Cure rate was seen in 58,3% to 76% after a single procedure in STDS studies and 70% to 94,11% overall success. Phenol’s studies demonstrated a 47.5% to 70% cure rate with one sclerotherapy and 96.5% to 100% overall success. In Sclerotheraphy with tetracycline cure rate after a single procedure was 57% to 100% and overall success was 77% to 100%. Of the polidocanol group, cure rate was 42.3% to 62.1% after one sclerotherapy and overall success was 51.7% to 94%. Finally, in alcohol’s group we found 50% to 76.12% after one procedure and 80% to 97.62%. Conclusion A better cure rate after one procedure was observed with tetracycline and overall success after multiples procedures was seen with phenol. Due to heterogeneity and biases of the studies, more controlled clinical trials must be done to elucidate the best sclerosant agents. Financing No conflict.

Metal artifact reduction sequence-MRI abnormalities in asymptomatic patients with dual-mobility hip prostheses.

Modular dual-mobility (DM) articulations are increasingly used during total hip arthroplasty (THA). However, concerns remain regarding the metal liner modularity. This study aims to correlate metal artifact reduction sequence (MARS)-MRI abnormalities with serum metal ion levels in patients with DM articulations. A total of 45 patients (50 hips) with a modular DM articulation were included with mean follow-up of 3.7 years (SD 1.2). Enrolled patients with an asymptomatic, primary THA and DM articulation with over two years' follow-up underwent MARS-MRI. Each patient had serum cobalt, chromium, and titanium levels drawn. Patient satisfaction, Oxford Hip Score, and Forgotten Joint Score-12 (FJS-12) were collected. Each MARS-MRI was independently reviewed by fellowship-trained musculoskeletal radiologists blinded to serum ion levels. Overall, two patients (4.4%) had abnormal periprosthetic fluid collections on MARS-MRI with cobalt levels > 3.0 μg/l. Four patients (8.9%) had MARS-MRI findings consistent with greater trochanteric bursitis, all with cobalt levels < 1.0 μg/l. A seventh patient had a periprosthetic fluid collection with normal ion levels. Of the 38 patients without MARS-MRI abnormalities, 37 (97.4%) had cobalt levels < 1.0 μg/l, while one (2.6%) had a cobalt level of 1.4 μg/l. One patient (2.2%) had a chromium level > 3.0 μg/l and a periprosthetic fluid collection. Of the 41 patients with titanium levels, five (12.2%) had titanium levels > 5.0 μg/l without associated MARS-MRI abnormalities. Periprosthetic fluid collections associated with elevated serum cobalt levels in patients with asymptomatic DM articulations occur infrequently (4.4%), but further assessment is necessary due to implant heterogeneity.

Association of C-Reactive Protein (CRP) Test Results with The Decision on Cytological Examination of Pleural Effusion Fluid

Background: Pleural effusion is an abnormal collection of fluid within the pleural lining resulting from a disturbance in the balance affecting the inflow and outflow from the area. Pleural fluid is associated with various medical diseases such as heart failure, pneumonia, and malignancy. Rapid and accurate diagnosis remains a major clinical challenge in patients with suspected pleural infection. As clinical data may be elusive, measurement of biomarkers in pleural fluid can estimate the likelihood of infection, and C-reactive protein (CRP) is the biomarker of choice for detecting inflammatory states.&#x0D; Method: The research method used in this study is descriptive research. This study was conducted at the anatomical pathology laboratory of Siloam Jambi Hospital in March - June 2023. The population in this study was 57 patients with pleural effusion. The samples in this study were all pleural effusion patients who performed Cytology and CRP examinations at Siloam Jambi Hospital from March-June 2023 at the Anatomical Pathology Laboratory Unit of Siloam Jambi Hospital.&#x0D; Result: The CRP test results in the group with cytology examination decision which were categorized in the inflammation group had an average of 6.6 ± 1.83 mg/L. CRP continued to increase in adenocarcinoma group (46 ± 19.03 mg/L) and metastatic carcinoma group (105.6 ± 48.68 mg/L). There was a very significant increase in the CRP test results along with an increase in the decision of the results of the pleural fluid cytology examination (p-value &lt;0.01).&#x0D; Conclusion: CRP test results show potential in predicting cytology examination decisions in patients with pleural effusion.

Eggshell calcified hydrocele sac: a case report

IntroductionHydrocele, an abnormal fluid collection between parietal and visceral layers of the tunica vaginalis, is the commonest cause of scrotal swelling, and it affects all age groups. Calcification of hydrocele sac/wall is a rare clinical entity. The etiology of calcification of hydrocele sac is not clear, but most literature proposes that calcification is secondary to chronic irritation. Trauma and infectious diseases including Schistosoma haematobium, filariasis, and tuberculosis can also cause calcification of the hydrocele sac.Case presentationA 74-year-old Ethiopian male patient presented with left side scrotal swelling of 3 years duration, which was initially small but progressively increased. He had no history of trauma, and he had no history of swelling on the contralateral side. Scrotal ultrasound (US) showed a large echodebrinous left-side scrotal collection with calcifications, bilateral testis appear normal in size, echogenicity, and color Doppler flow with the index of likely chronic hematocele. Therefore, with a diagnosis of left-sided calcified hydrocele, the patient was operated on and the calcified sac was excised and sent for histopathology. Finally, the patient was discharged improved after 2 days of hospital stay.ConclusionCalcification of the tunica vaginalis is very rare and is probably due to chronic irritation of the wall from the coexisting hydrocele. Surgical excision of calcified hydrocele sac is the treatment of choice.

METAL ARTIFACT REDUCTION SEQUENCE MRI ABNORMALITIES IN ASYMPTOMATIC PATIENTS WITH DUAL MOBILITY HIP PROSTHESES

Modular dual mobility (DM) articulations are increasingly utilized during total hip arthroplasty (THA). However, concerns remain regarding the metal liner modularity. This study aims to correlate metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) abnormalities with serum metal ion levels in patients with DM articulations.All patients with an asymptomatic, primary THA and DM articulation with &gt;2-year follow-up underwent MARS-MRI of the operative hip. Each patient had serum cobalt, chromium, and titanium levels drawn. Patient satisfaction, Oxford Hip Score, and Forgotten Joint Score-12 (FJS-12) were collected. Each MARS-MRI was independently reviewed by fellowship-trained musculoskeletal radiologists blinded to serum ion levels.Forty-five patients (50 hips) with a modular DM articulation were included with average follow-up of 3.7±1.2 years. Two patients (4.4%) had abnormal periprosthetic fluid collections on MARS-MRI with cobalt levels &gt;3.0 μg/L. Four patients (8.9%) had MARS-MRI findings consistent with greater trochanteric bursitis, all with cobalt levels &lt; 1.0 μg/L. A seventh patient had a periprosthetic fluid collection with normal ion levels. Of the 38 patients without MARS-MRI abnormalities, 37 (97.4%) had cobalt levels &lt;1.0 μg/L, while one (2.6%) had a cobalt level of 1.4 μg/L. One patient (2.2%) had a chromium level &gt;3.0 μg/L and a periprosthetic fluid collection. Of the 41 patients with titanium levels, five (12.2%) had titanium levels &gt;5.0 μg/L without associated MARS-MRI abnormalities.Periprosthetic fluid collections associated with elevated serum cobalt levels in patients with asymptomatic dual mobility articulations occur infrequently (4.4%), but further assessment of these patients is necessary.Level of Evidence: Level IV

Implanted Penile Prosthetic Visualized During Focused Assessment with Sonography for Trauma Examination: A Case Report.

This is a case report of an implanted penile prosthetic visualized during focused assessment with sonography for trauma (FAST) examination. The case represents a unique finding near the lateral bladder that may confound assessment of intraperitoneal fluid collections during initial assessment of trauma patients. A 61-year-old Black male was brought to the emergency department from a nursing facility for evaluation after sustaining a ground-level fall. A FAST exam demonstrated an abnormal fluid collection anterior and lateral to the bladder, later identified as an implanted penile prosthetic. Focused assessment with sonography for trauma examinations are often performed on unidentified patients in a time-sensitive manner. Understanding of potential false-positive results is crucial to appropriate use of the tool. This report demonstrates a novel false-positive result that may be difficult to differentiate from a true intraperitoneal bleed.

The incidence and clinical characteristics of myocarditis and pericarditis following mRNA-based COVID-19 vaccination in Republic of Korea adolescents from July 2021 to September 2022.

Age-specific information regarding myocarditis/pericarditis in adolescents following mRNA-based coronavirus disease 2019 (COVID-19) vaccination in Asia remains insufficient. This study investigated the incidence and clinical characteristics of myocarditis/pericarditis in Republic of Korea adolescents after mRNA-based COVID-19 vaccination. This retrospective descriptive study utilized patient data from the Korea Immunization Management System. Incidence rates were calculated according to age and sex. Clinical characteristics (symptoms/signs, laboratory values, and imaging results) were compared between mild and severe cases. Between July 19, 2021 and September 30, 2022, 3,728,224 individuals aged 12 to 19 years received 6,484,165 mRNA-based COVID-19 vaccines, and 173 cases met the case definition for myocarditis/pericarditis: 151 mild (87.3%) and 22 severe (12.7%). The incidence was 3.8-fold higher in males than in females. Troponin I/ troponin T was elevated in 96% of myocarditis cases, demonstrating higher sensitivity than creatine kinase-myocardial band (67.6%) or C-reactive protein (75.2%). ST-segment or Twave on electrography abnormalities were found in 60.3% (85/141). Paroxysmal/sustained atrial/ventricular arrhythmias were more common in severe than in mild cases (45.5% vs. 16.8%, p=0.008). Edema on T2-weighted magnetic imaging occurred in 21.6% (8/37) and 62.5% (5/8) of mild and severe cases, respectively (p=0.03). Abnormal pericardial fluid collection or pericardial inflammation was found in 75.4% of pericarditis cases (49/65). Myocarditis/pericarditis occurred in rare cases following mRNA-based COVID-19 vaccination. Most cases were mild, but the incidence was higher in adolescent males and after the second dose. As bivalent severe acute respiratory syndrome coronavirus 2 mRNA vaccination started in Republic of Korea in October 2022, the post-vaccination incidence of myocarditis/pericarditis should be closely monitored, considering clinical characteristics.

Endoscopic Fenestration of an Intra-ventricular Arachnoid Cyst in a Young Male – A Rare Entity

Introduction: Among intracranial space-occupying lesions, arachnoid cysts compromise 1% only. Abnormal collection of cerebrospinal fluid occurs in these types of cysts leading to pressure symptoms. Developmental abnormalities of cerebrospinal structures in early fetal life lead to the primary type of arachnoid cysts, while the second type of arachnoid cyst is formed after some neurological insult like head injury, tumor, meningitis, or brain surgery. In 60 – 90% of cases, the primary type predominates and presents with pressure symptoms before the age of 20 years. The adjudged incidence is 1.4% in adults, the least frequent being intraventricular location. Clinical Case: A 23-year-old male presented with a long-standing left-sided cranial vault headache, right-sided focal seizures, and progressive right- hemiparesis. Neurological evaluation revealed upper motor neuron signs on the right side of the body. A computerized axial tomography raised the suspicion of an arachnoid cyst for which magnetic resonance imaging was done which revealed a large intraventricular cyst of lateral ventricles causing mass effect over the ipsilateral hemisphere and mild obstructive hydrocephalous. Surgical intervention was required as per symptomology (intractable headache, seizures, and hemiparesis) and large cyst size. Conclusion: Cerebrospinal fluid accumulation in the brain's arachnoid layer causes non-cancerous arachnoid cysts. Larger cysts may push on brain tissue and cause neurological difficulties. MRI may diagnose arachnoid cysts, and treatment options include cystoperitoneal shunt, craniotomy, and neuro-endoscopic fenestration, the least invasive. Cyst size and location determine therapy. In this example, endoscopic treatment reduced symptoms and consequences.

Spontaneous intracranial hypotension: from cerebral venous thrombosis to neurosurgical treatment: a case series experience from a Brazilian tertiary health care center.

Spontaneous intracranial hypotension (SIH) is a secondary cause of headache and an underdiagnosed disease. The clinical presentation can be highly variable. It typically presents with isolated classic orthostatic headache complaints, but patients can develop significant complications such as cerebral venous thrombosis (CVT). To report 3 cases of SIH diagnosis admitted and treated in a tertiary-level neurology ward. Review of the medical files of three patients and description of clinical and surgical outcomes. Three female patients with SIH with a mean age of 25.6 ± 10.0 years old. The patients had orthostatic headache, and one of them presented with somnolence and diplopia because of a CVT. Brain magnetic resonance imaging (MRI) ranges from normal findings to classic findings of SIH as pachymeningeal enhancement and downward displacement of the cerebellar tonsils. Spine MRI showed abnormal epidural fluid collections in all cases, and computed tomography (CT) myelography could determine an identifiable cerebrospinal fluid (CSF) leak in only one patient. One patient received a conservative approach, and the other two were submitted to open surgery with laminoplasty. Both of them had uneventful recovery and remission in surgery follow-up. The diagnosis and management of SIH are still a challenge in neurology practice. We highlight in the present study severe cases of incapacitating SIH, complication with CVT, and good outcomes with neurosurgical treatment.

Cystic Hygroma, Hydrops Fetalis and Down Syndrome: A Case Report

Cystic hygroma and hydrops fetalis are commonly results of vascular lymphatic malformation that include abnormal fluid collection and an imbalance in the regulation of fluid leading to an increase in interstitial fluid production or a decrease in lymphatic return.

Excessive Fluid in the Lumbar Facet Joint as a Predictor of Radiological Outcomes After Lateral Lumbar Interbody Fusion.

Background Preoperative segmental instability maybe a predictor of postoperative outcomes when treated with lateral lumbar interbody fusion (LLIF). An abnormal collection of fluid within the facet joint has been described as a sign of segmental instability. The potential relationship between this radiological sign and its prognostic relevance for indirect decompression (ID) has not been investigated. Methods Clinical and radiologic results from patients undergoing LLIF in a single institution between 2007 and 2014 were evaluated retrospectively. Patients were divided into two groups: those presenting with excessive fluid (EF) in the facet joints on T2-MRI and those with a normal amount of facet fluid with less than 1mm, which were controls. Radiological parameters were foraminal height, disc height, Cobb angle, and lumbar lordosis. Results A total of 21 patients (43 operated levels) were evaluated pre- and postoperatively. Mean disc height, mean foraminal height, and coronal Cobb angles were statistically significantly improved after LLIF. Only the EF group showed significant improvement in radiological markers after ID; the mean disc height improved from 5.5±2 to 8.8±1mm (p=0.001), mean foraminal height improved from 16.88±3 to 20.53±3mm (p=0.002), and the mean Cobb angle improved from 27.7±16 to 14±13 (p=0.018). Conclusions Patients undergoing LLIF with the radiological findings of EF in the facet joints demonstrated significant improvement in radiological outcomes of ID. Further studies should validate these findings in larger data sets.

Comparison of Nathan alcohol formalin substitute fixative solution with 10% acetone-neutral buffered formalin in the preparation of cell blocks in ascitic fluid samples

Cytology is one of the fields related to the study of the morphology of individual cells or cells derived from microscopically observed tissue fragments. Ascites is an abnormal collection of fluid in the peritoneal cavity. The peritoneal cavity contains 50-100 ml of serous fluid . In this study, the method used is the cell block method by doing a comparison between cell blocks fixed with NAFS and cell blocks fixed with acetone-NBF with an assessment of the quality of cytology preparations based on Hematoxylin-Eosin staining according to the criteria in the scoring table, namely scores 1 (not good), 2 (poor), and 3 (good). Good fixation will produce good quality preparations to be assessed by pathologists. The purpose of this study was to determine the comparison of fixative solution of nathan alcohol formalin substitute with 10% acetone-neutral buffered formalin in the manufacture of cell blocks in ascitic fluid samples. This type of research is quantitative research with experimental research design.

Clinical study of the management of scrotal swelling in adult patients at a rural medical college and research hospital

Background: Scrotal swellings are commonest clinical entities in surgical practice. Hydrocele is abnormal collection of serous fluid in the tunica vaginalis or any part of the processus vaginalis, which needs to be differentiated from other conditions and surgically managed. Methods: This prospective, observational study was carried out on 90 adult male patients between January 2021 to August 2021 diagnosed with scrotal swelling, admitted, treated at MVJMC and RH. Inclusion criteria were male patients of age &gt;18 years. Exclusion criteria were patients with paediatric scrotal swellings. Routine blood investigations, COVID test and ultrasound of the scrotum was done. The patients underwent one of the standard surgical procedures and were observed for post-operative complications during their stay at the hospital and were followed up for 3 months. The collected data was analyzed using SPSS-21 software.Results: Collected data was analysed using SPSS-21. In our study hydrocele was seen in 48 (53.33%), epididymo-orchitis 5 (5.56%). 3 (3.33%) cases of varicocele, 2 (2.22%) cases of epididymal cyst and 1 (1.11%) each of sebaceous cyst, spermatocele, hematocele, sebaceous cyst, Fournier’s gangrene, infected encysted hydrocele, pyocele, scrotal abscess and filarial hydrocele. 2 (2.22%) testicular tumour and 21 (23.86%) testicular torsion. Of 90 patients 81 (90%) underwent surgery, while 9 (10%) patients were managed conservatively.Conclusions: Primary vaginal hydrocele was the commonest scrotal swelling. Ultrasound of the scrotum is diagnostic tool in differentiating from other swellings in the scrotum especially in testicular torsion when the testis can be saved. Jaboulay’s procedure was the commonest surgery performed with least complications.

A proposal of drain removal criteria in hepatobiliary resection.

Standardized criteria for drain removal in hepatobiliary resection are lacking. Here, we evaluated the outcomes of delayed removal policy in this extended surgery. Patients undergoing hepatectomy with biliary reconstruction between 2012 and 2018 were retrospectively reviewed. The drains were removed on postoperative day (POD) 7 when the drainage fluid was grossly serous, biochemically normal, and negative for bacterial contamination as assessed by Gram staining; additionally, no abnormal fluid collection was confirmed by computed tomography. Clinically relevant abdominal complications (CRACs), including biliary leakage, pancreatic fistula or intra-abdominal abscess, served as the primary outcome measure. Among 374 study patients, surgical drains were removed in 166 (44.3%) patients who met the criteria. Of these patients, 16 (9.6%) patients subsequently required additional drainage due to CRAC. Drains were retained and exchanged in 208 (55.6%) patients who did not meet the criteria. Of these, exchanged drains were soon removed in 34 patients due to no signs of CRAC. The diagnostic ability of the criteria revealed 0.916 sensitivity, 0.815 specificity, and 0.866 accuracy. The four findings on POD 7 worked well as criteria for drain removal, and these criteria may be helpful in drain management after hepatobiliary resection.

Unique case report of occupation associated recurrent loculated hydro-pneumothorax with interstitial lung disease

Hydro-pneumothorax is an abnormal collection of fluid and air in the pleural space. The knowledge of hydro-pneumothorax dates back to the days of ancient Greece when the Hippocratic succussion was used to be performed for the diagnosis Generally patient with hydro-pneumothorax presents with heaviness of the chest with chest pain, shortness of breath, dry cough and early fatigue. The patient in this case report presented with the above complaints along with that he was having structural thoracic kyphosis and grade 3 gynecomastia. He was working in a diamond industry as a diamond polisher. This case explains the role of occupation and hormones on the presentation and prognosis of respiratory disease.

Significance of Pseudomeningocele After Decompressive Surgery for Chiari I Malformation.

BackgroundPseudomeningoceles (PMCs) as abnormal collections of cerebrospinal fluid are quite common findings on follow-up MRI after Chiari decompression surgery (CDS). However, the importance of their identification has not been truly determined, especially when PMCs are described occasionally in the process of radiological follow-up. We retrospectively analyzed surgical outcomes and imaging findings after CDS depending upon the occurrence and thickness of PMCs.MethodsA total of 76 adult patients who underwent CDS were analyzed. The clinical and radiological outcomes of patients with a pseudomeningocele (wPMC) were evaluated and compared to those of patients without a pseudomeningocele (w/oPMC). Radiological morphometric measurements were performed and compared between groups. Comparisons of the maximal PMC thickness were made within the wPMC group.ResultsPMCs were recognized in 27 (35.5%) patients, of whom 3 (11.1%) required reoperation. Differences in satisfactory result rates regarding gestalt assessment and Chicago Chiari Outcome Scale were statistically insignificant between the w/oPMC and wPMC groups (p = 1 and p = 0.56, respectively). The postoperative syringomyelia decrease and cerebellar tonsil elevation were similar between the groups (p = 1 and p = 0.74, respectively) in the long-term follow-up. Additionally, the clinical or radiological outcomes with radiological details were not related to PMC thickness in the long-term follow-up. However, radiological details showed the cooccurrence of PMCs with a postsurgical of cerebello-tentorial distance increase (p < 0.05), basion-pontomedullary sulcus distance decrease (p < 0.05) and tonsillo-graft distance decrease (p < 0.05).ConclusionsWe found no significant relationships between PMC presence or thickness and clinical or radiological outcomes. However, postoperative changes within the posterior fossa associated with PMCs resemble brain sagging, which occurs in intracranial hypotension. Therefore, extradural cerebrospinal fluid escape may also be responsible for symptoms in some patients with PMCs after CDS.

Prenatal phenotyping for non-immune hydrops and other abnormal fluid collections

Many features of genetic diseases underlying non-immune hydrops fetalis (NIHF) and other abnormal fluid collections such as increased nuchal translucency (NT) are unclear. This limits identification of the underlying reason for abnormal fluid and the ability of genomic sequencing to accurately identify genetic diseases. We aimed to determine the unique fetal phenotypic features associated with single gene disorders in a large cohort of cases with NIHF and other abnormal fluid collections.

Placental phenotype in non-immune hydrops fetalis

Non-Immune hydrops fetalis (NIHF) is the presence of abnormal fluid collections in ≥ 2 fetal compartments in the absence of red cell alloimmunization. No studies to our knowledge have focused on the potential value of placental pathology in NIHF with negative standard workup.