Higher efficiency of frozen embryo transfer in male infertility cases in in vitro fertilization.

OBJECTIVE: The aim of the present study was to analyze the success rates of frozen and fresh embryo transfer methods in different patient groups. MATERIAL AND METHODS: The study included 453 patients who underwent in vitro fertilization (IVF) treatment. The patients were further divided into three groups as male factor, tubal/ovarian/uterine factor, and other factors. IVF treatment was performed through either fresh or frozen embryo transfer (FET). Of the 453 patients, 298 had fresh embryo transfer, and 155 received FET. The implantation and live-birth rates of FET were compared with fresh transfer approach, focusing on the effects of male infertility. RESULTS: There was a significant difference between the pregnancy ratios of patients who underwent fresh embryo transfer versus patients who underwent FET. In patients who were receiving IVF treatment due to male factors, the pregnancy rate was 49.32% in the fresh embryo transfer group, whereas it was 69.70% in the FET group, revealing a significant difference between the two groups (p=0.0321). Although the live-birth ratios were higher in the FET group both among all patients who underwent IVF due to male factor, the differences between the groups were not statistically significant. CONCLUSION: We observed higher pregnancy rates in FET patients compared with fresh embryo transfer in the study group. The differences in pregnancy rates and live-birth rates were especially evident in IVF cases where male factor was the reason for the treatment.

Providing Transthoracic Echocardiography Training for Intensive Care Unit Trainees: An Educational Improvement Initiative.

OBJECTIVE: Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees. Our hypothesis is that after the training, participants' will have improved knowledge and ultrasound skills compared to before training. Our secondary hypotheses are that TTE-naïve trainees will have greater improvements in knowledge scores compared to those who have had prior TTE experience and trainees will increase their use of TTE in the ICU. DESIGN: Single-center, prospective trial. SETTING: Brigham and Women's Hospital (academic hospital). PARTICIPANTS: Residents and fellows rotating through the ICU, at any level of postgraduate training. RESULTS: Forty-two trainees participated in the study. Statistically significant improvement after training was observed for all multiple choice questions (MCQ) and practical assessments (p < 0.001). When assessing the differences in score improvement between TTE-experienced versus TTE-naïve users, mean score improvements were notably higher for TTE-naïve participants (MCQ: 28.2 ± 11.6; echo clinical: 48.6 ± 23.4) compared to TTE-experienced users (MCQ: 18.6 ± 13.5, p = 0.01; echo clinical: 38.3 ± 30.2, p = 0.04). CONCLUSIONS: A short didactic presentation on TTE use may be useful in teaching ICU trainees basic TTE skills and encouraging the use of bedside TTE in the ICU.

The effects of dynamic airway photographs on preoperative airway planning among a panel of anesthetists.

STUDY OBJECTIVE: To determine whether having preoperative airway photographs will change the preanesthetic airway plan. DESIGN: Questionnaire. SETTING: American academic medical center (Brigham and Women's Hospital, Boston MA). SUBJECTS: Twenty-five test subjects (American Society of Anesthesiologists 1-4) were enrolled to have their preoperative airway photographs taken as well as to have a customary preoperative history and physical examination. In addition, 15 anesthetists were enrolled to review the subjects' preoperative history, physical examination, and preoperative airway photographs. MEASUREMENTS: All 15 anesthetists were asked to fill out a survey for airway management for each test subject. MAIN RESULTS: All 15 anesthetists completed the survey. Across all providers, plans were changed a median of 24% (95% confidence interval [CI], 12.7-38.6). Among attending anesthesiologists, airway management plans were changed 30% of the time (95% CI, 12.4-40.0), whereas among nonattending level providers, plans changed 24% of the time (95% CI, 12.0-38.8). χ2 Tests found no difference between the percent change of airway plans between attending and nonattending level providers (P=.306). CONCLUSIONS: Our findings suggest that the addition of dynamic airway photographs to preoperative airway reports affects airway management plans among a variety of anesthesia care providers. In general, dynamic airway photographs can aid preoperative airway management planning.

[Association of physiotherapy under continuous brachial plexus analgesia and shoulder arthrographic-distension for treatment of resistant shoulder-hand syndrome]. / Association d'une rééducation sous analgésie péri-nerveuse continue et d'une capsulo-distension de l'épaule dans le traitement du syndrome épaule-main rebelle.

OBJECTIVE: Evaluation of treatment of shoulder-hand syndromes resistant to conventional therapeutic. This approach consists of an intensive treatment based on arthrographic distension with rapid mobilization of the shoulder under general anaesthesia and on active rehabilitation under regional analgesia using infraclavicular brachial plexus catheter. MATERIAL AND METHODS: It was a retrospective study of twenty-five consecutive patients with severe shoulder-hand syndrome treated between 2007 and 2012. Besides their persistent pain, these patients presented a functional disability of their shoulder, wrist and hand. Treatment was initiated at least three months after diagnosis. All were assessed at the admission and six months later. RESULTS: After treatment, pain was reduced by at least three points at the NS in 64% of the patients. Twelve patients described a complete recovery of their shoulder function; eleven patients described a normal hand function recovery and six patients a partial recovery allowing regular life. Nineteen patients evaluated their functional improvement of more than 50%. Only two patients with more than one year of chronic pain reported no improvement after treatment. CONCLUSION: After failure of the physiotherapy and analgesic treatment, there are no clear consensual procedures and guidelines remains discussed. The current study combined different approaches with a significant improvement of this complex regional pain syndrome called shoulder-hand syndromes.

Radionuclide tracing of water masses and processes in the water column and sediment in the Algerian Basin.

Caesium-137 and (239,240)PU were analysed in the water column along the Algerian coast. The (137)Cs activity concentration in surface water increased from the west to the east from 1.6 to 3.3 mBq L(-1), documenting a presence of Modified Atlantic Water (MAW) in the region. Higher concentrations observed in deep waters may be due to an intrusion of Levantine Intermediate Water (LIW), which has been carrying higher levels of (137)Cs from Chernobyl accident. The (239,240)Pu sub-surface concentration peaked at about 250 m water depth as a result of biogeochemical processes in the water column. The observed (239,240)Pu/(137)Cs activity ratio at the surface (0.003) was significantly lower than that in global fallout (0.04). This decrease exceeds that expected from radioactive decay of (137)Cs, and confirms that Pu due to its adsorption on sinking particles is more effectively removed from surface layers than is (137)Cs. An increase of the (239,240)Pu/(137)Cs activity ratio with depth suggests that (239,240)Pu, similarly as (137)Cs, should be also transported by advection to maintain the observed ratios in deep waters. An intrusion of LIW may enhance therefore both the (137)Cs and (239,240)Pu concentrations in deep waters. The average (238)Pu/(239+240)Pu activity ratio in seawater was 0.03+/-0.02, confirming a global fallout origin of Pu in the Algerian Basin. Caesium-137 and (239,240)Pu inventories in the water column were estimated to be from 2.7+/-0.5 kBq m(-2) to 3.8+/-0.7 kBq m(-2), and from 13.8+/-2.6 Bq m(-2) to 41+/-7B qm(-2), respectively. The (137)Cs massic activities in surface sediment were almost constant, the average activity was 9.0+/-0.8 Bq kg(-1). Sedimentation rates obtained using the (210)Pb method were from 0.1 to 0.7 cm y(-1), and resulting penetration depths of (137)Cs in the sediment cores were from 15 to over 40 cm. The (137)Cs peaks found in the sediment cores were associated with the Chernobyl accident (1986) and global fallout (1964). The (137)Cs inventories in the sediment were increasing from the west (180 Bq m(-2)) to the east (350 Bq m(-2)).

The physical properties of oxygen-deficient perovskite SrPbO(3-δ).

The transport properties of oxygen-deficient perovskite SrPbO(3-δ) with mixed lead valency were investigated down to 4.2 K. The small δ-value (0.059), determined from iodometry, is due to the inert lone pair Pb(2+) that does not enjoy regular octahedral coordination in spite of collective electron behaviour. The oxide exhibits a temperature-independent magnetic susceptibility consistent with itinerant electrons. The sign of carriers like polarons is that of n-type conductivity coming from the balance charge via oxygen extraction. The thermal variation of conductivity and thermopower reveal the existence of an energy gap. The conduction mechanism occurs by polaron hopping in conformity with small activation energy. The metal-insulating transition seems to be of Anderson type, resulting from the disorder of oxygen vacancies. At low temperature, the conductivity was fitted to a variable range hopping [Formula: see text]. A comparison with SrSnO(3) will be reported. The covalency of Sn-O raises the antibonding conduction state of 5s parentage and increases the forbidden gap from 1.78 to 3.30 eV.

Policy of universal salt iodization in Bangladesh: do coastal people benefit?

Iodine deficiency disorders (IDD) are a serious public-health problem in Bangladesh and in other countries. Use of iodized salt has been promoted to solve the problem. A study was conducted in eight unions of Chakaria upazila in the Cox's Bazar district of Bangladesh during 1997-1998 to determine the prevalence of use of iodized salt, explore the reasons behind nonuse, and identify the socioeconomic correlates of its use. A quantitative survey was conducted to collect information from 21,190 households on socioeconomic status, demographic characteristics, and the kind of salt used. In-depth interviews and focus-group discussions were also conducted to understand the situation further. The results revealed that only 1.9% of the households used iodized salt. Strong barriers that limit their use of iodized salt included the wide availability of coarse salt, lack of knowledge about the link between iodized salt and IDD, and the high cost of iodized salt. Households in the salt-producing localities and those that are economically disadvantaged tend to use iodized salt less than others. Understanding of the prevalent situation will allow the policy-makers to take measures to improve the situation in the salt-producing areas.

Gender inequality and severe malnutrition among children in a remote rural area of Bangladesh.

Bangladesh typifies many south-eastern countries where female children experience inferior health and uncertain survival, especially after the neonatal period. This paper attempts to study the gender inequality in nutritional status and the effects of various socioeconomic, demographic, and health-programme factors on gender inequality in a remote rural area of Bangladesh. Measurements of mid-upper arm circumference (MUAC) were taken from 2,016 children aged less than 5 years (50.8% male, 49.2% female) in 1994. Children were characterized as severely malnourished if MUAC was < 125 mm. Independent variables included various characteristics of children, households, and mothers. Average MUAC for all children was 130 mm; 33% were severely malnourished. Of the severely-malnourished children, 54.2% were female, and 45.8% were male. The gender gap persisted in the multivariate situation, with female 1.44 times more likely to be severely malnourished. Other variables with a statistically significant relationship included the age of children, acceptance of DPT1, and education of household heads. The persistence of such a gender discrimination now when the country has achieved a lot in terms of child survival is striking. The issue is important and demands appropriate corrective actions.

Acute renal failure among a Syrian population. Incidence, aetiology, treatment and outcome.

This prospective study involved 102 patients who had acute renal failure and were treated at Aleppo University Hospital during the period 1980-1986. Acute renal failure in this group was categorized, according to the aetiology, into 12 causes. Obstructive uropathy, surgery, and crush injuries constituted 64% of all cases in males. In females, 56% of all cases were due to obstetrical trauma, acute glomerulonephritis and eclampsia. Haemodialysis was used for the treatment of 77 patients, with 65% cure, and 33% mortality. Conservative treatment was adopted for 21 patients with 62% cure, and 38% mortality. Four patients were treated by peritoneal dialysis, and they all survived. The prognosis in the studied group depended on the aetiology of acute renal failure, and accompanying risk factors such as infection, electrolyte disturbances, encephalopathy, failure of other end organs, etc. It was also found that patients presenting with anuria or oliguria had worse prognosis when compared with patients who had normal urine output.