RESUMO
Although pregnant neurofibromatosis or HIV patient established a high-risk group, this report demonstrated that a careful planning and widespread valuations should be associated with a favorable prognosis for both mother and newborn.
RESUMO
A 25-year-old woman presented to the obstetric clinic in her first pregnancy. The patient was accompanied by her mother who reported an episode of intracerebral hemorrhage after birth and also remembered access to the emergency department after generalized tonic-clonic seizure as an infant. She was not able to describe the therapy for seizure preventions and even when and why it was suspended, but she affirmed that no residual neurological consequences were detected in the following years. Actually, the pregnant woman was in good health without neurological symptoms nor assumed any therapy. A neurologist reviewed the patient's CT scan in which arachnoid cyst and porencephalic cyst were evident, and he assessed that no abnormalities were found in motor, sensory, and mental state examination. EEG did not show any epileptiform or seizure-like activity. No antiepileptic drug was prescribed due to the absence of symptoms since many years. The patient had no neurological symptoms during pregnancy or obstetric complications and delivered at term a healthy baby through a caesarean section. She breastfed, and after two years, the patient and the baby are healthy. The association of porencephalic and arachnoid cyst in pregnancy is an extremely rare neurological condition that needs a multidisciplinary counseling in pregnancy, but an uneventful course is possible.
RESUMO
BACKGROUND/AIM: To evaluate the cost-effectiveness of multiparametric magnetic imaging resonance (mpMRI) in men submitted to repeat saturation prostate biopsy (SPBx). MATERIALS AND METHODS: From January 2011 to June 2017, 800 men underwent repeat SPBx; the cost-effectiveness of mpMRI if used as a 'triage test' to avoid unnecessary repeat prostate biopsy was retrospectively calculated using the Italian Public National Health System Day Service. RESULTS: SPBx vs. MRI fusion targeted biopsy diagnosed 215 (89.5%) vs. 184 (76.6%) out of 240, respectively. The overall cost of the 800 prostate biopsies was 138,221 ; the use of mpMRI as triage test would have spared 364/800 procedures, equivalent to 60,905 (44% of the entire cost), whilst missing 15/205 (7.3%) cases of clinically significant cancer. CONCLUSION: mpMRI used as a triage test could reduce the need for prostate biopsies by about 45%, thereby improving cost-effectiveness, however, patients should be informed of the false-negative rate associated with mpMRI.
