Prospective observational comparison of arteria uterina blood flow between two frozen embryo transfer cycle regimens: natural cycle versus hormonal replacement cycle.

PURPOSE: Is there a difference in the blood flow of the Arteria uterina in frozen embryo transfer (FET) cycles between a Natural Cycle (NC) and a Hormonal Replacement Therapy (HRT) cycle? METHODS: Prospective observational study with measurement of the pulsatility index (PI) and resistance index (RI) throughout the ovarian stimulation cycle for IVF/ICSI, the FET cycle and at 12 weeks of gestation. RESULTS: A total of 124 ovarian stimulation cycles with preimplantation genetic testing for aneuploidy (PGT-A) and "freeze-all" strategy due to PGT-A were included. Mean patient's age was 31.4 years, mean BMI 26.47 kg/m2, mean AMH 3.62 ng/ml and a mean AFC of 13. FET cycles were performed in 77 patients (NC protocol: 37.7%, HRT protocol: 62.2%). The overall pregnancy rate was 75%, (NC group: 79%, HRT-group 73%; not significant). No significant change of PI and RI was seen during hormonal stimulation. In FET cycles, there was a significant increase between cycle day 2/3 and ovulation/P4-start in the HRT-cycle, followed by a significant decrease until 12 weeks of gestation. The slope of the decrease in patients with a pregnancy in an HRT-approach was a bit steeper than in the NC-approach for both PI and RI, however, without a significant difference. CONCLUSIONS: Early measurements of the blood flow parameters during the FET cycle do not reveal a difference between the NC- and the HRT-approach for FET, which could be predictive for development of pre-eclampsia.

Second-trimester screening for trisomy-21 using prefrontal space ratio.

OBJECTIVE: To investigate the potential value of prefrontal space ratio (PFSR) in second-trimester screening for trisomy-21. METHODS: A retrospective study utilizing stored midsagittal two-dimensional images of fetal profiles in 240 euploid and 45 trisomy-21 pregnancies at 16(+0)-23(+6) weeks' gestation. The vertical distance between the leading edge of the skull and that of the skin (D1) and the distance between the skull and the mandibulo-maxillary line (D2) were measured and the D1:D2 ratio (PFSR) was calculated. In euploid pregnancies, regression analysis was used to determine the association between D1, D2 and PFSR with gestational age (GA). D1 and D2 were expressed as delta (Δ) values with gestational age. ΔD1, ΔD2 and PFSR in cases and controls were compared. RESULTS: In trisomy-21, compared to controls, ΔD1 was increased (1.417 vs. 0.000 mm, p < 0.0001), ΔD2 was decreased (-0.842 vs. 0.000 mm, p = 0.003) and PFSR was increased (0.753 vs. 0.463, p < 0.0001). At a false-positive rate of 5%, the detection rates in screening by ΔD1, ΔD2 and PSFR were 80.0% (95% CI 65.4-90.4), 46.7% (95% CI 31.7-62.1) and 100.0% (95% CI 92.1-100.0), respectively. CONCLUSION: The PFSR is an effective marker in second-trimester screening for trisomy-21.

Surgical treatment of bronchobiliary fistulas due to complicated echinococcosis of the liver: case report and literature review.

Echinococcosis still remains a widespread disease associated with the development of a number of complications. The present study presents three patients, successfully treated surgically of bronchobiliary fistulas--in two of the patients the fistulas were due to complicated echinococcosis of the liver, and in the third patient the fistula was a result of a hepatic abscess which developed in a residual cavity after echinococcectomy. The patients were discharged from hospital in good health. The authors consider thoracophrenotomy to be the method of choice in the surgical treatment of patients with bronchobiliary fistulas; it allows performance of echinococcectomy and elimination of the bronchobiliary fistula. The results are discussed in relation to relevant data in literature.

Blood-gas and acid-base profile in dogs with severe pancreatitis.

A number of systemic disorders develop in the clinical course of acute pancreatitis. Among these important are the respiratory disorders occurring in 35-55% of the patients. They develop in the first hours after onset of pancreatitis and are the cause of death in 60% of the severe forms of acute pancreatitis. We studied the changes in the arterial blood oxygen status and acid-base status in experimentally induced severe acute pancreatitis in dogs. The animals were divided into two groups--one receiving sandostatin treatment and the other without treatment. Quickly progressing acute arterial hypoxemia was observed in the dogs with severe acute pancreatitis. Hypoxemia development was delayed by administration of sandostatin.

Maternal serum retinol-binding protein-4 at 11-13 weeks' gestation in normal and pathological pregnancies.

OBJECTIVE: To examine maternal serum levels of retinol-binding protein-4 (RBP4) at 11-13 weeks' gestation in normal and pathological pregnancies. METHODS: Serum RBP4 at 11-13 weeks was measured in 480 singleton pregnancies, including 240 with normal outcome, 60 that subsequently developed preeclampsia (PE), 60 that developed gestational diabetes mellitus (GDM), 60 that delivered large for gestational age (LGA) neonates and 60 that delivered small (SGA) neonates. The values in each adverse pregnancy outcome group were compared to those of normal pregnancies. RESULTS: Serum concentration of RBP4 was not significantly different in women who subsequently developed PE (p=0.925), or GDM (p=0.074), or had pregnancies that led to delivery to SGA (p=0.085), LGA (p=0.332) neonates. CONCLUSION: Maternal serum RBP4 in the first trimester is not significantly altered in pathological pregnancies.

Low-grade pulmonary myxoid liposarcoma.

Primary pulmonary liposarcoma is extremely rare. There are only 12 cases reported in the literature. We presented a case of low-grade primary pulmonary myxoid liposarcoma, which was diagnosed and underwent surgery in our clinic. The diagnosis was established after imaging investigations (X-ray and CT), histologic and immunohistochemical examinations. The patient was followed up one year after the operation.