Impact of assisted reproduction treatment on sexual function of patients diagnosed with infertility.

PURPOSE: This study aims to update and systematize the existing evidence on the prevalence of sexual dysfunction and depression in infertile couple Renatos undergoing assisted reproduction treatments. METHODS: A bibliographic search regarding sexual dysfunction in infertile couples was performed on PubMed and LILACS, with no restrictions on the date of publication of the article. The Newcastle-Ottawa Scale (NOS) was used to evaluate studies quality. Data collection process was conducted using a form previously planned and tested, extracting the goal information in a descriptive way. RESULTS: From 111 records, only eight prospective studies were included in the synthesis. Although most of the selected studies assessed only women, three studies assessed the couple. All of them used questionnaires that showed that infertile couples experienced a higher number of sexual dysfunctions during the infertility treatment process, especially women. Regarding depression, going through the infertility process and its treatment leads to significant emotional damage to the patient or couple. CONCLUSION: Of the eight studies analyzed, six reached the conclusion that infertility is related to higher rates of sexual dysfunction. Seven studies also concluded that anxiety and depression are more prevalent in infertile patients. The treatment of sexual dysfunction is multidisciplinary, with the team being a general practitioner, gynecologist, psychologist and specialized nurse. If an organic disorder is detected, there may be a need to include specialists such as urology, gastroenterology and anesthesia. Psychological approaches often include some combination of sex education, identification of emotional and cultural factors, and eventually, couples therapy.

Treatment of heterotopic caesarean scar pregnancy complicated with post termination increase in size of residual mass and morbidly adherent placenta.

We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining "mass" increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy. This case illustrates a complication of the intervention performed to preserve the intrauterine gestation in case of HCSP. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:227-230, 2018.

Transplacental sildenafil rescues lung abnormalities in the rabbit model of diaphragmatic hernia.

INTRODUCTION: The management of congenital diaphragmatic hernia (DH) would benefit from an antenatal medical therapy, which addresses both lung hypoplasia and persistent pulmonary hypertension. We aimed at evaluating the pulmonary effects of sildenafil in the fetal rabbit model for DH. METHODS: We performed a dose-finding study to achieve therapeutic fetal plasmatic concentrations without toxicity following maternal sildenafil administration. Subsequently, DH fetuses were randomly exposed to transplacental placebo or sildenafil 10 mg/kg/day from gestational day 24 until examination at term (day 30). Efficacy measures were ipsilateral pulmonary vascular and airway morphometry, micro-CT-based branching analysis, Doppler flow in the main pulmonary artery and postnatal lung mechanics. RESULTS: Fetal sildenafil plasmatic concentration was above the minimal therapeutic level for at least 22 h/day without maternal and fetal side effects. The placebo-exposed DH fetuses had increased wall thickness in peripheral pulmonary vessels and significantly less fifth-order vessels compared with controls (CTR). Sildenafil-exposed DH fetuses, instead, had a medial and adventitial thickness in peripheral pulmonary vessels in the normal range and normal vascular branching. Fetal pulmonary artery Doppler showed a reduction of pulmonary vascular resistances both in DH and in CTR fetuses treated by sildenafil compared with the placebo-treated ones. Sildenafil also reversed the mean terminal bronchiolar density to normal and improved lung mechanics, yet without measurable impact on lung-to-bodyweight ratio. CONCLUSIONS: In the rabbit model for DH, antenatal sildenafil rescues vascular branching and architecture, reduces pulmonary vascular resistances and also improves airway morphometry and respiratory mechanics.

Ultrasound scan as a potential source of nosocomial and crossinfection: a literature review.

The authors review the main concepts regarding the importance of cleaning/disinfection of ultrasonography probes, aiming a better comprehension by practitioners and thus enabling strategies to establish a safe practice without compromising the quality of the examination and the operator productivity. In the context of biosafety, it is imperative to assume that contact with blood or body fluids represents a potential source of infection. Thus, in order to implement cleaning/disinfection practice, it is necessary to understand the principles of infection control, to consider the cost/benefit ratio of the measures to be implemented, and most importantly, to comprehend that such measures will not only benefit the health professional and the patient, but the society as a whole.

Os autores revisam os principais conceitos relativos à importância da limpeza/desinfecção das sondas ecográficas, visando sua melhor compreensão e possibilitando, assim, estabelecer estratégias para uma prática segura sem comprometer a qualidade do exame e a produtividade do operador. No contexto da biossegurança, é imperativo assumir que o contato com sangue ou fluidos corporais representa uma potencial fonte de infecção. Dessa forma, para que as práticas de limpeza/desinfecção possam ser instituídas, é necessário entender os princípios do controle de infecção, ponderar se os benefícios das medidas a serem instituídas são compatíveis com seus custos e consequências, e principalmente compreender que tais medidas não beneficiam apenas o profissional de saúde e o paciente, mas a sociedade como um todo.

Ultrasound scan as a potential source of nosocomial and cross-infection: a literature review / O exame ultrassonográfico como potencial fonte de infecção cruzada e nosocomial: uma revisão da literatura

AbstractThe authors review the main concepts regarding the importance of cleaning/disinfection of ultrasonography probes, aiming a better comprehension by practitioners and thus enabling strategies to establish a safe practice without compromising the quality of the examination and the operator productivity. In the context of biosafety, it is imperative to assume that contact with blood or body fluids represents a potential source of infection. Thus, in order to implement cleaning/disinfection practice, it is necessary to understand the principles of infection control, to consider the cost/benefit ratio of the measures to be implemented, and most importantly, to comprehend that such measures will not only benefit the health professional and the patient, but the society as a whole.

ResumoOs autores revisam os principais conceitos relativos à importância da limpeza/desinfecção das sondas ecográficas, visando sua melhor compreensão e possibilitando, assim, estabelecer estratégias para uma prática segura sem comprometer a qualidade do exame e a produtividade do operador. No contexto da biossegurança, é imperativo assumir que o contato com sangue ou fluidos corporais representa uma potencial fonte de infecção. Dessa forma, para que as práticas de limpeza/desinfecção possam ser instituídas, é necessário entender os princípios do controle de infecção, ponderar se os benefícios das medidas a serem instituídas são compatíveis com seus custos e consequências, e principalmente compreender que tais medidas não beneficiam apenas o profissional de saúde e o paciente, mas a sociedade como um todo.