Two-dimensional ultrasound results in underestimation of the ovarian follicle size compared to automated three-dimensional imaging in women undergoing IVF.

BACKGROUND: Traditionally, for the assessment of follicle growth during IVF, two-dimensional (2D) transvaginal ultrasound (US) is used. In the past few years three-dimensional (3D) US has also been introduced. OBJECTIVES: To compare follicular sizes between 2 and 3D ultrasound imaging on the final day of controlled ovarian stimulation. METHODS: A prospective observational cohort study including 121 women undergoing controlled ovarian stimulation (COS) between January 2017 and July 2018. All women were assessed by transvaginal 2D and 3D ultrasonography to measure ovarian follicle dimensions on the final day of COS. RESULTS: The mean difference in paired comparisons between the 3D and 2D US measurements in 25 women with monofollicular development was + 1.6 ± 2.5 mm for the x-dimension and + 1.7 ± 2.4 mm for the y-dimension; and in the total number of 1197 paired measurements of follicles the mean difference + 2.1 ± 3.3 mm and + 1.8 ± 3.9 mm for the x- and y-dimension respectively. In all cases the paired t-test showed that differences were statistically significant (p < 0.01). Further it was conjectured that the 2D underestimation results from the inherent difficulty to precisely place the US probe simultaneously on the perpendicular maximal of the x and y follicle diameters, leading to measurement errors that, by theory, are normally distributed. Running Monte-Carlo simulations based on these measurement errors it was found that both the mean difference and standard deviation are of the same magnitude as the ones found in real measurements, thus proving the conjecture. CONCLUSIONS: The utilisation of 3D US results in different measurements of the follicular dimensions, and volumes, when compared to conventional 2D US. The differences in the x- and y-dimensions may affect the outcome of an IVF cycle as they are used to define the day of triggering final oocyte maturation, which is associated with the yield of mature oocytes and the probability of live birth.

Kinetics of circulating immunoglobulin M in sepsis: relationship with final outcome.

INTRODUCTION: The aim of this study was to investigate the kinetics of immunoglobulin M (IgM) during the different stages of sepsis. METHODS: In this prospective multicenter study, blood sampling for IgM measurement was done within the first 24 hours from diagnosis in 332 critically ill patients; in 83 patients this was repeated upon progression to more severe stages. Among these 83 patients, 30 patients with severe sepsis progressed into shock and IgM was monitored daily for seven consecutive days. Peripheral blood mononuclear cells (PBMCs) were isolated from 55 patients and stimulated for IgM production. RESULTS: Serum IgM was decreased in septic shock compared to patients with systemic inflammatory response syndrome (SIRS) and patients with severe sepsis. Paired comparisons at distinct time points of the sepsis course showed that IgM was decreased only when patients deteriorated from severe sepsis to septic shock. Serial measurements in these patients, beginning from the early start of vasopressors, showed that the distribution of IgM over time was significantly greater for survivors than for non-survivors. Production of IgM by PBMCs was significantly lower at all stages of sepsis compared with healthy controls. CONCLUSIONS: Specific changes of circulating IgM occur when patients with severe sepsis progress into septic shock. The distribution of IgM is lower among non-survivors.

Effects of wi-fi signals on the p300 component of event-related potentials during an auditory hayling task.

The P300 component of event-related potentials (ERPs) is believed to index attention and working memory (WM) operation of the brain. The present study focused on the possible gender-related effects of Wi-Fi (Wireless Fidelity) electromagnetic fields (EMF) on these processes. Fifteen male and fifteen female subjects, matched for age and education level, were investigated while performing a modified version of the Hayling Sentence Completion test adjusted to induce WM. ERPs were recorded at 30 scalp electrodes, both without and with the exposure to a Wi-Fi signal. P300 amplitude values at 18 electrodes were found to be significantly lower in the response inhibition condition than in the response initiation and baseline conditions. Independent of the above effect, within the response inhibition condition there was also a significant gender X radiation interaction effect manifested at 15 leads by decreased P300 amplitudes of males in comparison to female subjects only at the presence of EMF. In conclusion, the present findings suggest that Wi-Fi exposure may exert gender-related alterations on neural activity associated with the amount of attentional resources engaged during a linguistic test adjusted to induce WM.

Principal component analysis of the P600 waveform: RF and gender effects.

The aim of the present study was to examine the patterns of activation of the P600 waveform of the event-related potentials (ERP), applying principal component analysis (PCA) and repeated measures ANOVA, and whether these patterns are RF and gender dependent. The ERPs of thirty-nine healthy subjects (20 male and 19 female) were recorded during an auditory memory task in the presence and absence of RF, similar to that emitted by mobile phones. Both PCA and ANOVA produced congruent results, showing that activation of the P600 component occurs early and more intensely in the region of the posterior electrodes and in a less intense manner in the central electrodes. Conversely, the activation at the anterior electrodes arises later with a considerably reduced intensity. In the absence of RF female subjects exhibited significantly lower amplitudes at anterior electrodes and earlier latencies at central electrodes than male subjects. These differences disappear in the presence of RF. Consequently, the P600 component follows distinct patterns of activation in the anterior, central and posterior brain areas and gender differences are observed simultaneously at several electrodes within these areas. Finally, the gender-related functional architecture with regard the P600 component appears to be RF sensitive. In conclusion, the application of the PCA procedure provides an adequate model of the spatially distributed event-related dynamics that correspond to the P600 waveform.

The spectral power coherence of the EEG under different EMF conditions.

The present study introduces the concept of spectral power coherence (SPC), which reflects the pattern of coordination of the four basic EEG bands (delta, theta, alpha, and beta) at a specific location of the brain. The SPC was calculated for the pre-stimulus EEG signal during an auditory memory task under different electromagnetic field (EMF) conditions (900 MHz and 1800 MHz). The results showed that delta rhythm is less consequential in the overall cooperation between the bands than the higher frequency theta, alpha and beta rhythms. Additionally, it has been shown that the radiation effect on SPC is different for the two genders. In the absence of radiation males exhibit higher overall SPC than females. These differences disappear in the presence of 900 MHz and are reversed in the presence of 1800 MHz.