BACKGROUND
Questions remain as to whether surgical excision of ovarian endometriomas might cause damage to ovarian function. To test the hypothesis that ovarian surgery for endometrioma compromises ...ovarian function and accelerates ovarian failure.
METHODS
In a tertiary university Clinic, longitudinal prospective cohort study. Patients who underwent laparoscopy for endometriosis between March 1993 and November 2007 were assessed for inclusion in the study. A prospective follow-up at 3, 6 and 12 months then yearly was conducted. Evolution of menstrual pattern, symptoms and reproductive outcomes were investigated.
RESULTS
From over the 14-year period, 302 patients were included in the study. The mean age (±SD) of patients was 32.6 ± 5.6 years; the median duration of follow-up was 8.5 years (range 2–17 years). Menopause was documented in 43 women (14.3%) at a mean age of 45.3 ± 4.3 years (range 32–52 years). Women previously submitted to bilateral cystectomy were younger at menopause than those with monolateral endometrioma (42.1 ± 5.1 years versus 47.1 ± 3.5 years, P = 0.003). Premature ovarian failure (POF) was observed in 7 of 43 (16.3%) menopausal patients; the majority (4, 57.1%) after bilateral cystectomy. The relationship between the preoperative ovarian endometriomas total diameter and menopausal age was significant in case of surgery for bilateral endometriomas (R2 = 0.754, P = 0.002).
CONCLUSIONS
Patients who had been operated on for bilateral endometriomas have an increased risk of POF. Ovarian parenchyma loss at the time of surgery seems related to cyst diameter. In the case of unilateral ovarian endometrioma, the contralateral intact ovary might adequately compensate.
In this cross-sectional study, the accuracy of Cameriere’s European formula was tested and a new specific model was developed for two samples of black and white South African children with known age ...and sex. For these purposes, 970 children of black South African ethnicity (girls 491, boys 479) and 974 with European ethnicity, living in South Africa (girls 493, boys 481), were retrospectively analyzed. The application of the European formula showed that there is a trend in the error estimates: the ages of the younger children are overestimated and those of the older children are underestimated, in both white and black children. A new model, based on the relationship between the apical width and the tooth length (maturity index) of the seven permanent mandibular teeth, was therefore constructed. The new developed equation for the South African population was able to explain 76% of total variance in white girls and 80% in white boys’ subgroup. On the other side, the model explained 76% of total variance in black girls and 78% in the black boys’ subgroup. The mean absolute error of the residuals (residuals = predicted age minus observed age) ranged from 0.718 to 0.769 years, with the interquartile range (IQR
res
) ranging from 1.19 to 1.31 years. Differently from the Cameriere’s European formula, the plot did not tend to underestimate the chronological age significantly as the age increases. Cameriere’s maturity index is reproducible in both samples of South African black and white children, for forensic purposes, and the Bayesian calibration approach is useful for a more accurate and precise estimation.
Aims
The evaluation of the cutoff value of I
3M
= 0.08 for discriminating black South African minors from adults, and its relationship with chronological age.
Material and methods
A sample of 833 ...panoramic radiographs of healthy black South African subjects (500 females and 333 males), in the age range of 14 to 24 years (mean age 17.67 years in females and 17.42 years in males), was retrospectively evaluated.
Results
ICC values were 99.10% (95% CI 97.70 to 99.70%) and 99.20% (95% CI 98.00 to 99.60%), for the intra- and inter-observer reliability, respectively. I
3M
decreased as the real age gradually increased in both sexes. According to the logistic regression model, the variable sex was not significant when the probability that an individual is 18 years or older was calculated. The I
3M
= 0.08 was valuable in discriminating between adults and minors. The overall accuracy (ACC = fraction of accurately classified subjects) is 0.90 (95% CI 0.87–0.91); the proportion of correctly classified subjects (Se = sensitivity) is 0.80 (95% CI 0.76–0.84), and specificity (Sp) is 0.95 (95% CI 0.93–0.97). The PPV (predictive positive value) is 0.96 (95% CI 0.95–0.97), and the negative predictive value is 0.76 (95% CI 0.72–0.80).
Conclusion
The results show that I
3M
is a valuable method to distinguish subjects who are around legal adult age in South Africa.
The validity of third molar index (I
3
M
= 0.08) for discriminating minors from adults was tested in a sample of 620 panoramic radiographs of Lebanese subjects (293 females and 327 males), aged ...between 14 and 23 years. The technical error of measurements (TEM), the relative technical error of measurements (rTEM), the coefficient of reliability (R) and the Intraclass Correlation Coefficient (ICC) were calculated for testing intra- and inter-observer agreement. The I
3
M
values gradually decreased as age (years) increased across all the age groups in both sexes. For females, the sensitivity and specificity of the test were 0.61 (95% CI: 0.53-0.69) and 0.97 (95% CI: 0.93-0.98), respectively. The sensitivity and specificity for males were 0.63 (95% CI: 0.56-0.70) and 0.89 (95% CI: 0.83-0.93), respectively. The accuracy values (number of correct assessments) were 0.79 (95% CI: 0.74-0.83) for females and 0.74 (95% CI: 0.70-0.79) for males. Estimated post-test probabilities were 0.97 (95% CI: 0.91-0.99) for females and 0.90 (95% CI: 0.83-0.94) for males. The I
3
M
was a useful further indicator for discriminating between adults and minors in this Lebanese sample of adolescents and young adults.
Highlights • The various stages of the use of type I interferon in multiple sclerosis were reviewed. • We focused on the possible effects of the treatment on the supposed viral etiologic factors that ...have been associated to multiple sclerosis. • An analysis was performed to compare multiple sclerosis-associated genes and components of the interferon-beta pathway.
A pilot project aimed at testing roe enhancement strategies based on offshore Paracentrotus lividus cultures was conducted off the south‐east coast of Italy (Apulia Region). Adult sea urchins were ...reared in sea cages located 700 m offshore at a depth of 12 m for 3 months. The animals were fed once a week on two formulated diets, prepared mixing nutrients with agar 20 g/Kg and differing only in terms of the protein source: anchovy flour (Diet A) or krill flour (Diet K). At the end of the rearing trial, the gonad somatic index of sea urchins fed on formulated diets significantly exceeded that of wild sea urchins. Total FAA content in the gonads of wild sea urchins and Diet A‐fed sea urchins was similar, whereas in Diet K‐fed sea urchins it was significantly higher. In terms of fatty acids, the gonads contained SFAs, MUFAs and PUFAs. In visual and sensory assessment of gonads by panel test and electronic nose, the gonads of reared sea urchins were rated as being of better size, while no differences were recorded for coloration, taste and odour. This study shows that under these experimental conditions, commercial‐grade Paracentrotus lividus roe enhancement can be achieved after 3 months in sea cages.
Objective The objective of the study was to evaluate the prevalence of cancer and premalignant lesions in polyps on atrophic endometrium in asymptomatic postmenopausal women to compare these findings ...with a similar cohort of patients with abnormal uterine bleeding. Study Design One thousand one hundred fifty-two asymptomatic and 770 consecutive postmenopausal women with abnormal uterine bleeding were included in a retrospective multicenter study. Recruited patients underwent hysteroscopic polypectomy based on a sonohysterographic or hysteroscopic diagnosis. The pathologic report was the main outcome measure. Results One single case of stage 1 grade 1 endometrial carcinoma on a polyp with a mean diameter of 40 mm (0.1%) was observed in asymptomatic women. This prevalence was 10 times lower than in symptomatic patients ( P < .0001). The prevalence of atypical hyperplastic polyps was 1.2% in asymptomatic women (2.2% in symptomatic patients; P < .005). At multivariate analysis, polyps' diameter was the only variable significantly associated to an abnormal histology (cancer, polypoid cancer, and atypical hyperplasia) in asymptomatic women (odds ratio for polyps with mean diameter > 18 mm, 6.9; confidence interval, 2.2-21.4). Conclusion Follow-up and/or treatment of endometrial polyps incidentally diagnosed in asymptomatic postmenopausal patients could be safely restricted to few selected cases based on polyp diameter.
Background
Several randomised controlled trials (RCTs) have investigated the usefulness of pituitary block with gonadotrophin‐releasing hormone (GnRH) antagonists during intrauterine insemination ...(IUI) cycles, with conflicting results.
Objective
The aim of the present systematic review and meta‐analysis of RCTs was to evaluate the effectiveness of GnRH antagonist administration as an intervention to improve the success of IUI cycles.
Search strategy
Electronic databases (MEDLINE, Scopus, EMBASE, Sciencedirect) and clinical registers were searched from their inception until October 2017.
Selection criteria
Randomised controlled trials of infertile women undergoing one or more IUI stimulated cycles with GnRH antagonists compared with a control group.
Data collection and analysis
The primary outcomes were ongoing pregnancy/live birth rate (OPR/LBR) and clinical pregnancy rate (CPR). Pooled results were expressed as odds ratio (OR) or mean differences with 95% confidence interval (95% CI). Sources of heterogeneity were investigated through sensitivity and subgroups analysis. The body of evidence was rated using GRADE methodology. Publication bias was assessed with funnel plot, Begg's and Egger's tests.
Main results
Fifteen RCTs were included (3253 IUI cycles, 2345 participants). No differences in OPR/LBR (OR 1.14, 95% CI 0.82–1.57, P = 0.44) and CPR (OR 1.28, 95% CI 0.97–1.69, P = 0.08) were found. Sensitivity and subgroup analyses did not provide statistical changes in pooled results. The body of evidence was rated as low (GRADE 2/4). No publication bias was detected.
Conclusion
Pituitary block with GnRH antagonists does not improve OPR/LBR and CPR in women undergoing IUI cycles.
Tweetable
Pituitary block with GnRH antagonists does not improve the success of IUI cycles.
Tweetable
Pituitary block with GnRH antagonists does not improve the success of IUI cycles.
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