Animals ; Humans ; Tetralogy of Fallot ; embryology ; etiology

Adolescent ; Adult ; Child ; Female ; Heart Defects, Congenital ; etiology ; genetics ; prevention & control ; Humans ; Pregnancy

Adolescent ; Adrenergic beta-Agonists ; therapeutic use ; Adult ; Asthma ; drug therapy ; Bronchodilator Agents ; therapeutic use ; Butylamines ; therapeutic use ; Ethanolamines ; therapeutic use ; Female ; Heart Rate ; drug effects ; Hemodynamics ; drug effects ; Humans ; Injections, Subcutaneous ; Male ; Regional Blood Flow ; drug effects ; Resorcinols ; therapeutic use

Adult ; Aerosols ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Female ; Humans ; Male

Adult ; Aged ; Ascariasis ; surgery ; Common Bile Duct Diseases ; surgery ; Female ; Humans ; Male

Given the consensus that there is a causal relationship between Zika virus (ZIKV) infection in pregnancy and congenital Zika syndrome (CZS), clinicians must be prepared to manage affected patients despite the numerous gaps in current knowledge. The clinical course in pregnancy appears similar to that in non-pregnant women, although viraemia may be prolonged. ZIKV infection can be diagnosed by serum and urine reverse transcription-polymerase chain reaction, but commercially available serological tests are currently unreliable in dengue-endemic regions. Although vertical transmission can occur at any time during gestation, first- and second-trimester infections have the highest risk of developing central nervous system anomalies. Aberrant fetal growth and pregnancy loss may also occur. Serial ultrasonography should be conducted for infected cases. Without a vaccine, pregnant women should be advised to minimise mosquito bites and reduce sexual transmission risk. Overall, the absolute risk of CZS arising amid a ZIKV outbreak appears relatively low.

A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus. The patient's symptoms resolved during his hospitalisation and he was subsequently discharged well on long-term oral anticoagulation therapy. Isolated acute embolic occlusion of the coeliac axis is a rare occurrence that may result in end-organ infarction. Treatment options include systemic anti-coagulation, mechanical thrombectomy, catheter thrombolysis or open surgery. Catheter-directed thrombolysis therapy is a feasible and effective option for treating acute thromboembolic occlusion of the coeliac artery.