Hysterosalpingo-foam sonography versus hysterosalpingography during fertility work-up: an economic evaluation alongside a randomized controlled trial.

Study Question: What are the costs and effects of tubal patency testing by hysterosalpingo-foam sonography (HyFoSy) compared to hysterosalpingography (HSG) in infertile women during the fertility work-up?

Summary Answer: During the fertility work-up, clinical management based on the test results of HyFoSy leads to slightly lower, though not statistically significant, live birth rates, at lower costs, compared to management based on HSG results.

What Is Known Already: Traditionally, tubal patency testing during the fertility work-up is performed by HSG. The FOAM trial, formally a non-inferiority study, showed that management decisions based on the results of HyFoSy resulted in a comparable live birth rate at 12 months compared to HSG (46% versus 47%; difference -1.

Can hysterosalpingo-foam sonography replace hysterosalpingography as first-choice tubal patency test? A randomized non-inferiority trial.

Study Question: Does hysterosalpingo-foam sonography (HyFoSy) lead to similar pregnancy outcomes, compared with hysterosalpingography (HSG), as first-choice tubal patency test in infertile couples?

Summary Answer: HyFoSy and HSG produce similar findings in a majority of patients and clinical management based on the results of either HyFoSy or HSG, leads to comparable pregnancy outcomes. HyFoSy is experienced as significantly less painful.

What Is Known Already: Traditionally, tubal patency testing during fertility work-up is performed by HSG.

Effectiveness and safety of the tri-iodothyronine analogue Triac in children and adults with MCT8 deficiency: an international, single-arm, open-label, phase 2 trial.

Background: Deficiency of the thyroid hormone transporter monocarboxylate transporter 8 (MCT8) causes severe intellectual and motor disability and high serum tri-iodothyronine (T) concentrations (Allan-Herndon-Dudley syndrome). This chronic thyrotoxicosis leads to progressive deterioration in bodyweight, tachycardia, and muscle wasting, predisposing affected individuals to substantial morbidity and mortality. Treatment that safely alleviates peripheral thyrotoxicosis and reverses cerebral hypothyroidism is not yet available.

The FOAM study: is Hysterosalpingo foam sonography (HyFoSy) a cost-effective alternative for hysterosalpingography (HSG) in assessing tubal patency in subfertile women? Study protocol for a randomized controlled trial.

Background: Tubal pathology is a causative factor in 20% of subfertile couples. Traditionally, tubal testing during fertility work-up is performed by hysterosalpingography (HSG). Hysterosalpingo-foam sonography (HyFoSy) is a new technique that is thought to have comparable accuracy as HSG, while it is less expensive and more patient friendly.

Long-term follow-up after surgery in localized laryngeal amyloidosis.

To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence rate, revision surgery, progression to systemic amyloidosis, and changes in voice were monitored yearly.

Diagnosing Nodular Regenerative Hyperplasia of the Liver Is Thwarted by Low Interobserver Agreement.

Background And Aims: Nodular regenerative hyperplasia (NRH) of the liver is associated with several diseases and drugs. Clinical symptoms of NRH may vary from absence of symptoms to full-blown (non-cirrhotic) portal hypertension. However, diagnosing NRH is challenging.

An instrument dedicated for modelling of pulmonary radiotherapy.

Background And Purpose: Radiotherapy plays a pivotal role in lung cancer treatment. Selection of patients for new (radio)therapeutic options aiming at improving outcomes requires reliable and validated prediction models. We present the implementation of a prospective platform for evaluation and development of lung radiotherapy (proPED-LUNG) as an instrument enabling multidimensional predictive modelling.

A prospective study on the morbidity resulting from calvarial bone harvesting for intraoral reconstruction.

Calvarial bone grafts are used for reconstruction of the maxilla or mandible to enable implant placement. The aim of this study was to assess the morbidity resulting from the use of calvarial bone grafts to reconstruct the maxilla and mandible. Thirty-six consecutive patients were included in this prospective study (14 men and 22 women; mean age 59 ± 8.

FIGO's ethical recommendations on female sterilisation will do more harm than good: a commentary.

The International Federation of Gynecology and Obstetrics (FIGO) Committee for the Ethical Aspects of Human Reproduction and Women's Health advises against tubal occlusion (TO) performed at the time of caesarean section (CS/TO) or following a vaginal delivery (VD/TO) if this sterilisation has not been discussed with the woman in an earlier phase of her pregnancy. This advice is neither in accordance with existing medical custom nor evidence based. Particularly in less-resourced locations, adherence to it would deny much wanted one-off sterilisation opportunities to hundreds of thousands of women, many of whom have no reliable contraceptive alternative.

Long-term results of mucosal advancement flap combined with platelet-rich plasma for high cryptoglandular perianal fistulas.

Background: The long-term closure rate of high perianal fistulas after surgical treatment remains disappointing.

Objective: The goal of this study was to improve the long-term closure rate of high cryptoglandular perianal fistulas combining mucosal advancement flap with platelet-rich plasma.

Design: This study was retrospective in design.

Transvaginal posterior colporrhaphy combined with laparoscopic ventral mesh rectopexy for isolated Grade III rectocele: a prospective study of 27 patients.

Aim: The aim of this study was to evaluate prospectively transvaginal posterior colporrhaphy (TPC) combined with laparoscopic ventral mesh rectopexy (LVR) in patients with a symptomatic isolated rectocele.

Method: Patients with these complaints underwent dynamic and static MRI. All consecutive patients with a Grade III (4 cm or more) rectocele and without internal/external rectal prolapse, enterocele and external sphincter damage were operated on.

Laparoscopic fistula excision and omentoplasty for high rectovaginal fistulas: a prospective study of 40 patients.

Aim: The aim of this study is to prospectively evaluate 40 patients with a high rectovaginal fistula treated by a laparoscopic fistula division and closure, followed by an omentoplasty.

Patients And Methods: Forty patients with a rectovaginal fistula, between the middle third of the rectum and the posterior vaginal fornix, resulting from different causes (IBD, iatrogenic and birth trauma) were treated by a laparoscopic excision of the fistula and insertion of an omentoplasty in the rectovaginal septum. The patients completed the gastrointestinal quality of life index questionnaire (GIQLI) and the Cleveland Clinic incontinence score (CCIS).

Autologous platelet-derived growth factors (platelet-rich plasma) as an adjunct to mucosal advancement flap in high cryptoglandular perianal fistulae: a pilot study.

Aim: The aim of this study was to explore autologous platelet-rich plasma as an adjunct to the staged mucosal advancement flap in the treatment of perianal fistulae.

Method: Between February 2006 and May 2007, 10 patients with fistula tracts transversing from the middle-third or upper part of the anal sphincter were treated for at least 3 months with noncutting setons prior to definitive closure by autologous platelet-rich plasma as an adjunct to a mucosal advancement flap. Five patients smoked tobacco.

Keratin profiling in the developing human prostate. A different approach to understanding epithelial lineage.

Background: Keratin profiling studies in the developing human prostate have characterized cells thought to be stem cells and so-called intermediate cells. In a series of human prostates of various gestational ages, we extended on these studies using a comprehensive panel of keratin antibodies.

Materials And Methods: Autoptic tissue from 19 fetal prostates, gestational ages between 16 and 40 weeks, were immunostained with a panel of keratin antibodies: these recognize the luminal type keratins 7, 8, 18, 19, 20 and the basal/squamous type keratins 5, 6, 13, 14, 17.

Asthma genetics and intermediate phenotypes: a review from twin studies.

It has been long recognised that asthma and related phenotypes have an important hereditary nature, in which inheritance does not follow the classical Mendelian patterns and the exact mode of inheritance is not known. Linkage, association studies and genome-wide screening suggest that many genes are involved in the pathogenesis of asthma. Twin studies have contributed significantly to our understanding on the genetics of asthma, especially the large-scale twin studies in different parts of the world which have showed comparable results.

The long-term efficacy and safety profile of barnidipine.

Two multicentre trials have investigated the efficacy and tolerability of treatment with once-daily barnidipine, in patients with mild to moderate essential hypertension. The long-term efficacy and safety of barnidipine were demonstrated in a long-term, multicentre, open-label study. In total, 106, 79 and 32 patients were followed for the first, second and third year, respectively.

Iris-Claw intraocular lenses in children.

27 children (38 eyes) with cataracts of different origins were treated using iris fixated one-piece Iris-Claw intraocular lenses. Visual acuities outcome in this group was comparable with the results in other series. The Iris-Claw lens is a very versatile IOL, which can be used in most cataract procedures, it can be removed and exchanged with minimal surgical trauma; therefore it is an effective modality in correction of the developmental changes in the refraction of the very young and growing, aphakic eye.

Antibiotic prophylaxis in abdominal hysterectomy, with special reference to the duration of the prophylaxis.

Two consecutive open studies were performed of the efficacy of a prophylactic cefuroxime/metronidazole combination in abdominal hysterectomy. The first group received a 24-h regimen, the second group a single pre-operative dose. The incidence of post-operative wound infections and urinary tract infections were similar in both groups [wound infections in 1/75 versus 2/84 patients (NS), urinary tract infections 4/75 versus 3/84 patients (NS), respectively, in the 24-h group and single-dose group].

Refractive surgery for high myopia. The Worst-Fechner biconcave iris claw lens.

Surgical correction of high myopia is indicated in a limited number of cases. Techniques include (epi)keratophakia, keratomileusis and implantation of a negative-power IOL. The iris claw lens, fixed to the midperiphery of the iris, has proved its safety in aphakic eyes.

The irrigating knife: an ultrasharp surgical blade with irrigating system.

We present an irrigating microsurgical knife for ocular surgery. Irrigation of balanced salt solution through the knife tip during sectioning removes hemorrhages continuously, allowing uninterrupted sectioning, without cauterization of bleeding vessels. The "zero degree" knife can be bent in any required position.

Iris reconstruction by coloboma repair.

If a pupil becomes irreversibly miotic during cataract surgery it is helpful to perform an iridotomy to facilitate lens expression. Reconstructing the pupil with one or two iris sutures is advisable in order to prevent coloboma-related problems. We describe a method of iridoplasty that involves using a vanadium steel suture attached to a long, straight needle.

Epidural sufentanil for cancer pain control in outpatients.

Fifteen patients with cancer pain refractory to other methods of pain control were treated with epidural sufentanil. They all suffered from very severe or unbearable pain but had expressed the wish to spend the last period of their lives at home. On the first day of hospitalization, an epidural catheter and a portal catheter were implanted under local anesthesia.