Abstract
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility; however, whether women with PCOS and spontaneous or drug-induced ovulatory cycles have the same ...reproductive potential as non-PCOS controls is a matter of debate. In the present opinion paper, the author takes the opportunity to summarize the collective evidence supporting the hypothesis of reduced fertility potential in women with PCOS, regardless of ovulatory status, and speculate that reduced reproductive potential may be caused by altered oocytes, embryo and endometrial competence, and infertility-related co-morbidities as well as an increased risk of pregnancy complications.
Uterine transplantation (UTx) associated with IVF restores fertility in women affected by absolute uterine factor infertility (AUFI). Pregnancies achieved both in women undergoing any solid organ ...transplantation and following IVF are associated with an increased risk of maternal and neonatal complications. This systematic review evaluated this risk in UTx-IVF treated women focusing on the safety and efficacy features of the treatment. Twenty-two studies and three press releases reporting on 52 UTx-IVF treatments were identified. Regarding the safety of treatment, 38/52 (73,1%) of surgical procedures led to the restoration of uterine function in recipients, 12/52 (23,1%) of recipients experienced post-operative complications requiring hysterectomy, and 2/52 (3,8%) of procedures failed before uterine recipients' surgery due to intra-operative complications. Regarding the efficacy of treatment, results focused on transplanted patients showing full recovery of organ functioning: 16/38 (42,1%) of patients achieved a pregnancy, including two women who gave births twice. UTx-IVF pregnancies led to 16 deliveries and all new-borns were healthy. Six out of 16 (37,5%) UTx pregnancies faced major complications during gestation. Preterm births occurred in 10/16 (62,5%) UTx deliveries. Our data indicates that the risk of gestational and delivery complications deserves important consideration in AUFI women receiving UTx-IVF treatments. However, these observations are preliminary and need to be revised after larger series of data are published.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Photonic integrated circuits (PICs) are revolutionizing nanotechnology, with far-reaching applications in telecommunications, molecular sensing, and quantum information. PIC designs rely on mature ...nanofabrication processes and readily available and optimised photonic components (gratings, splitters, couplers). Hybrid plasmonic elements can enhance PIC functionality (e.g., wavelength-scale polarization rotation, nanoscale optical volumes, and enhanced nonlinearities), but most PIC-compatible designs use single plasmonic elements, with more complex circuits typically requiring ab initio designs. Here we demonstrate a modular approach to post-processes off-the-shelf silicon-on-insulator (SOI) waveguides into hybrid plasmonic integrated circuits. These consist of a plasmonic rotator and a nanofocusser, which generate the second harmonic frequency of the incoming light. We characterize each component's performance on the SOI waveguide, experimentally demonstrating intensity enhancements of more than 200 in an inferred mode area of 100 nm
, at a pump wavelength of 1320 nm. This modular approach to plasmonic circuitry makes the applications of this technology more practical.
Metformin is an insulin sensitizer widely used for the treatment of patients affected by type 2 diabetes mellitus. Because many women with polycystic ovary syndrome (PCOS) are insulin resistant, ...metformin was introduced in clinical practice to treat these patients also. Moreover, metformin’s effect has other targets beside its insulin-sensitizing action. The present review was aimed at describing all evidence-based and potential uses of metformin in PCOS patients. In particular, we will analyze the uses of metformin not only for the treatment of all PCOS-related disturbances such as menstrual disorders, anovulatory infertility, increased abortion, or complicated pregnancy risk, hyperandrogenism, endometrial, metabolic and cardiovascular abnormalities, but also for the prevention of the syndrome.
Plasmonics is considered as one of the most promising candidates for implementing the next generation of ultrafast and ultracompact photonic circuits. Considerable effort has been made to scale down ...individual plasmonic components into the nanometer regime. However, a compact plasmonic source that can efficiently generate surface plasmon polaritons (SPPs) and deliver SPPs to the region of interest is yet to be realized. Here, bridging the optical antenna theory and the recently developed concept of metamaterials, we demonstrate a subwavelength, highly efficient plasmonic source for directional generation of SPPs. The designed device consists of two nanomagnetic resonators with detuned resonant frequencies. At the operating wavelength, incident photons can be efficiently channeled into SPP waves modulated by the electric field polarization. By tailoring the relative phase at resonance and the separation between the two nanoresonators, SPPs can be steered to predominantly propagate along one specific direction. This novel magnetic nanoantenna paves a new way to manipulate photons in the near-field, and also could be useful for SPP-based nonlinear applications, active modulations, and wireless optical communications.
The demand for effective, real-time environmental monitoring and for customized point-of-care (PoC) health, requires the ability to detect low molecular concentrations, using portable, reliable and ...cost-effective devices. However, traditional techniques often require time consuming, highly technical and laborious sample preparations, as well as expensive, slow and bulky instrumentation that needs to be supervised by laboratory technicians. Consequently, fast, compact, self-sufficient, reusable and cost-effective lab-on-a-chip (LOC) devices, which can perform all the required tasks and can then upload the data to portable devices, would revolutionize any mobile sensing application by bringing the testing device to the field or to the patient. Integrated enhanced Raman scattering devices are the most promising platform to accomplish this vision and to become the basic architecture for future universal molecular sensors and hence an artificial optical nose. Here we are reviewing the latest theoretical and experimental work along this direction.
The aim of the current study was to compare the safety of the laparoscopic vs abdominal approach to staging endometrial cancer. A search was conducted for randomized controlled trials that reported ...data from women with histologically confirmed endometrial cancer who underwent laparoscopic or abdominal surgery. An additional metaanalysis was performed. The primary endpoints were the rates of intraoperative and postoperative complications. A total of 8 original randomized controlled trials were included in the final analysis. No significant difference was observed in the relative risk (RR) for intraoperative complications between laparoscopy and laparotomy (RR, 1.25; 95% confidence interval, 0.99–1.56; P = .062). In contrast, a significant advantage of laparoscopy over laparotomy was obtained in terms of postoperative complications (RR, 0.71; 95% confidence interval, 0.63–0.79; P = .016). In comparison with abdominal surgery, the safety of the laparoscopic approach for surgical staging of endometrial cancer is similar in terms of intraoperative complications but results in fewer postoperative complications.
Background Although widely adopted, the use of a uterine manipulator during laparoscopic treatment of endometrial cancer represents a debated issue, and some authors hypothesize that it potentially ...may cause an increased risk of relapse, particularly at specific sites. Objective Our aim was to evaluate the risk and site of disease recurrence, overall survival, and disease-specific survival in women who had laparoscopic surgery with and without the use of a uterine manipulator. Study Design Data were reviewed from consecutive patients who had laparoscopic surgery for endometrial cancer staging in 7 Italian centers. Subjects were stratified according to whether a uterine manipulator was used during surgery; if so, the type of manipulator was identified. Multivariable analysis to correct for possible confounders and propensity score that matched the minimize selection bias were utilized. The primary outcome was the risk of disease recurrence. Secondary outcomes were disease-specific and overall survival and the site of recurrence, according to the use or no use of the uterine manipulator and to the different types of manipulators used. Results We included 951 patients: 579 patients in the manipulator group and 372 patients in the no manipulator group. After a median follow-up period of 46 months (range,12–163 months), the rate of recurrence was 13.5% and 11.6% in the manipulator and no manipulator groups, respectively ( P =.37). Positive lymph nodes and myometrial invasion of >50% were associated independently with the risk of recurrence after adjustment for possible confounders. The use of a uterine manipulator did not affect the risk of recurrence, both at univariate (odds ratio, 1.18; 95% confidence interval, 0.80–1.77) and multivariable analysis (odds ratio, 1.00; 95% confidence interval, 0.60–1.70). Disease-free, disease-specific, and overall survivals were similar between groups. Propensity-matched analysis confirmed these findings. The site of recurrence was comparable between groups. In addition, the type of uterine manipulator and the presence or not of a balloon at the tip of the device were not associated significantly with the risk of recurrence. Conclusion The use of a uterine manipulator during laparoscopic surgery does not affect the risk of recurrence and has no impact on disease-specific or overall survival and on the site of recurrence in women affected by endometrial cancer.
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