This study compares the miscarriage rate of pregnancies after trans-myometrial eggs retrieval to transvaginal eggs retrieval.
In the period between January 2004 and December 2020, 13,323 egg ...retrievals were carried out. In 699 cases, the ovaries were unreachable. Alternative maneuvers were performed to solve this problem, but despite this, in 132 patients the technique of trans-myometrial sampling had to be used. 26 patients were excluded from the study, because of the inclusion criteria, and therefore two groups of 106 patients were selected, Group A and Group B (control).
In the comparison between the two groups, there were no statistically significant differences in abortion rates, pregnancy rates and complications after the technique.
This study shows that the abortion rate in trans-myometrial oocyte retrieval does not change when compared to classic retrieval, despite the sampling needle completely crossing the myometrium. Furthermore, the pregnancy rate and the complication rate do not appear to have worsened with this technique.
HSP are a group of genetically and clinically heterogeneous neurologic disorders. Hereby, we describe a relatively large group of patients (pts) affected by HSP studied at baseline (31 pts) and at ...follow up (mean period 28.9±8.4 months; 23 pts) with multimodal advanced MRI: high resolution T1 images for VBM analysis, MRS and DTI. An age-matched healthy control (HC) group underwent in a time schedule matched with HSP patients the same neuroimaging protocol. At the baseline VBM showed GM reduction in HSP in the right pre-frontal cortex and bilaterally in the thalami. MRS at baseline depicted in HSP patients compared to the HC group reduction of NAA/Cr ratio in the right pre-frontal region, increase of Cho/Cr ratio in the right pre-central regions, and increase of mI/Cr ratio on the left pre-central area. At cross-sectional follow up analysis and longitudinal evaluation no VBM and MRS statistical results were obtained. Tract-based spatial statistics (TBSS) analysis depicted widespread DTI brain white matter (WM) alterations in patients compared to HC at baseline, characterized by reduction of FA and increase of MD, AD and RD, confirmed on cross analysis of follow-up dataset. Longitudinal analysis of TBSS analysis in HSP patients didn't show significant variations, while applying region-based analysis we found increased FA, decreased MD and AD during follow-up in specific brain WM fibers complex. The changes were not correlated with the clinical presentation (pure vs complicated HSP), motor function and motility indexes (SPRS) or history of specific treatments (botulinum toxin). In conclusion, the cross-sectional analysis of the multiparametric MRI data in our HSP patients confirmed the no prominent involvement of the cortex in the primary motor regions, but rather of other more associative areas. On the contrary, DTI demonstrated a widespread involvement of the brain WM, including the primary motor regions, which was confirmed at follow up. The longitudinal analysis revealed an apparent inversion of tendency considering the expected evolution of a neurodegenerative process: we detected an increase of FA and a decrease of MD and AD. These time-related modifications may suggest a repair attempt by the residual central WM fibers.
W-band (v congruentwith 94 GHz) electron paramagnetic resonance (ERR) spectroscopy was used for a single-crystal study of a star-shaped Fe sub(3) Cr single-molecule magnet (SMM) with ...crystallographically imposed trigonal symmetry. The high resolution and sensitivity accessible with W-band ERR allowed us to determine accurately the axial zero-field splitting terms for the ground (S = 6) and first two excited states (S = 5 and S = 4). Furthermore, spectra recorded by applying the magnetic field perpendicular to the trigonal axis showed a pi/6 angular modulation. This behavior is a signature of the presence of trigonal transverse magnetic anisotropy terms whose values had not been spectroscopically determined in any SMM prior to this work. Such in-plane anisotropy could only be justified by dropping the so-called "giant spin approach" and by considering a complete multispin approach. From a detailed analysis of experimental data with the two models, it emerged that the observed trigonal anisotropy directly reflects the structural features of the cluster, i.e., the relative orientation of single-ion anisotropy tensors and the angular modulation of single-ion anisotropy components in the hard plane of the cluster. Finally, since high-order transverse anisotropy is pivotal in determining the spin dynamics in the quantum tunneling regime, we have compared the angular dependence of the tunnel splitting predicted by the two models upon application of a transverse field (Berry-phase interference).
Abstract In some cases of aortic valve leaflet disease, the implant of a stentless biological prosthesis represents an excellent option for aortic valve replacement (AVR). In particular, if compared ...to more classical surgical approaches, it provides a more physiological hemodynamic performance and a minor trombogeneticity avoiding the use of anticoagulants. The clinical outcomes of AVR are strongly dependent on an appropriate choice of both prosthesis size and replacement technique, which are, at present, strictly related to surgeon's experience and skill. Therefore, also this treatment, like most reconstructive procedures in cardiac surgery, remains “more art than science” 1 . Nowadays computational methodologies represent a useful tool both to investigate the aortic valve behavior, in physiologic and pathologic conditions and to reproduce virtual post-operative scenarios. The present study aims at supporting the AVR procedure planning through a patient-specific Finite Element Analysis (FEA) of stentless valve implantation. Firstly, we perform FEA to simulate the prosthesis placement inside the patient-specific aortic root; then, we reproduce, again by means of FEA, the diastolic closure of the valve to evaluate both the coaptation and the stress/strain state. The simulation results prove that both the valve size and the anatomical asymmetry of the Valsalva sinuses affect the prosthesis placement procedure.
Abstract Background Short–term left ventricle mechanical assistance device could be useful in assist interventional cardiologist during high–risk procedures. Abiomed Impella is one of the most ...frequently used device in this respect due to the high flow available with a low rate of reported complications. Here we report a rare but potentially catastrophic complication related to the Impella device. Case Description A 78 years old patient was referred to our Division by a peripheral hospital for a severe, symptomatic (NYHA III) mitral regurgitation (MR) due to posterior mitral leaflet prolapse (with focal eversion of P3) and chordal rupture (Fig 1a). Medical history included a previous admission in the some hospital due to a scheduled Impella–assisted PTCA (left main/left anterior descending artery) . Pre–procedural trans–thoracic ECHO (TTE) did not show significant MR (Fig 1b). Results Patient underwent urgent surgical procedure. At operation postero–medial mitral commissure was seen to be completely everted with multiple rupture of P3 and A3 chordae. Surgical procedure (Fig 1c) included: P3 plication + posterior–medial commissure edge–to–edge plasty + complete mitral semi–rigid ring (Simulus) n.30. Left atrial appendage was also closed using an external Atriclip. Postoperative course was without significant complications except a superficial wound dehiscence which delayed hospital discharge till 20th postoperative day. Conclusion Despite being a feasible and attractive option for short–term mechanical circulation assistance during high–risk interventional procedure, Impella device insertion could cause significant mitral valve damage leading to clinical deterioration. Such potentially catastrophic complication should be, therefore, mandatory excluded before patient discharge following interventional procedure.
Findings of standard MR imaging examinations are usually normal in primary CD. These findings are now increasingly challenged by studies using advanced neuroimaging techniques detecting abnormalities ...in brain areas that may be functionally involved in the pathophysiology of CD. Our purpose was to evaluate GM volumes in patients with CD at baseline and 5 years later.
We enrolled 19 patients (F/M = 15:4, mean age = 53.2 + 11.2 years), 12 of whom were studied at baseline and again approximately 5 years later. Twenty-eight healthy volunteers acted as controls (F/M = 17:11, mean age = 47.5 + 15.6 years). The subjects were imaged with a 1.5T scanner by using a 3D T1-weighted sequence on 150 contiguous axial 1-mm-thick sections to apply VBM.
At entry, VBM analysis disclosed significantly lower GM volumes in the left caudate head and putamen and in the premotor and primary sensorimotor cortices bilaterally in patients than in controls. No correlation was found between decreased GM volumes and patient age, severity of dystonia, or disease duration. At the 5-year follow-up, GM volumes in the left primary sensorimotor cortex in patients had decreased significantly from baseline.
The findings obtained at entry and after a 5-year follow-up consistently showed decreased caudate, putamen, and sensorimotor cortex GM volumes in patients with CD, and they probably play a pathophysiologic role in CD.
Diffusion tensor imaging (DTI) analyses the movement of water molecules within the cerebral white matter thus providing information on ultrastructural brain changes. We studied 18 patients with ...cervical dystonia (CD), 16 with blepharospasm (BSP) and 35 years age‐matched healthy controls. DTI data were obtained with a Philips 1.5 Tesla scanner and then processed to obtain maps of fractional anisotropy (FA) and mean diffusivity (MD). Twenty‐three square regions of interest of uniform size were positioned on the FA maps and then automatically transferred to the MD maps. FA and MD values in the corpus callosum, left and right putamen, right caudate, left and right pre‐frontal cortical area and left supplementary motor area in CD patients differed significantly from those in healthy controls. No significant regional differences were found between patients with BSP and healthy controls. In the CD group, age, duration and severity of dystonia did not correlate with regional FA/MD values, whereas the duration of botulinum toxin treatment correlated significantly with the MD value in the right‐pre‐frontal cortex. The abnormal DTI findings in patients with CD suggest the presence of brain ultrastructural changes in adult‐onset primary CD.
Background: It is the traditional view that primary dystonia arises from abnormal basal ganglia function but causes no apparent morphological changes. Objective: To determine whether cervical ...dystonia leads to ultrastructural changes in the brain, using diffusion tensor imaging to compare brain structure in 15 patients with cervical dystonia with 10 healthy controls. Design: Fractional anisotropy (FA) and mean diffusivity (MD) were obtained in 17 brain regions of interest. Results: Patients had higher FA values than controls in both putamina and lower FA values in the genu and in the body of the corpus callosum. Patients also had lower MD values in the left pallidum, the left putamen, and both caudati. Conclusions: In patients with cervical dystonia, diffusion tensor imaging shows ultrastructural changes in specific brain areas, including the basal ganglia.
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