Imaging After Nellix Endovascular Aneurysm Sealing: A Consensus Document.

Endovascular aneurysm sealing (EVAS) using the Nellix system is a new and different method of abdominal aortic aneurysm repair. Normal postoperative imaging has unique appearances that change with time; complications also have different and specific appearances. This consensus document on the imaging findings after Nellix EVAS is based on the collective experience of the sites involved in the Nellix EVAS Global Forward Registry and the US Investigational Device Exemption Trial.

Cervical dilatation thresholds for initiation of group B streptococcus antibiotic prophylaxis for women with spontaneous preterm labor.

Objective: To determine the optimal time for initiating group B streptococcus (GBS) antibiotic prophylaxis for women in spontaneous preterm labor.

Methods: In total, 227 women delivering singleton infants after presenting with spontaneous preterm labor and intact membranes at 24 0/7-36 6/7 weeks were evaluated, as well as 150 undelivered women with threatened preterm labor during the same time period. The date and time of each cervical examination throughout labor were recorded.

A comparison of three types of therapies for three different ovulation disorders in establishing pregnancies and evaluation of laboratory parameters that could influence the outcome.

Purpose: To evaluate the empirical use of progesterone (P) in the luteal phase for unexplained infertility.

Methods: Clinical and live-delivered pregnancy rates in three treatment cycles were compared in women with unexplained infertility vs women taking follicle maturing drugs for women completely anovulatory or those who release the oocyte before the follicle is mature.

Results: There was insufficient power to show a significant difference in the 19.

Effect of poor motility on pregnancy outcome following intracytoplasmic sperm injection in couples whose male partners have subnormal hypo-osmotic swelling test scores.

Purpose: To determine the confounding effect, if any, of poor motility of sperm that are already compromised by an abnormal hypo-osmotic swelling (HOS) test on pregnancy outcome following in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI).

Materials And Methods: Clinical and live-delivered pregnancy and implantation rates were retrospectively evaluated in first cycles of couples undergoing IVF-ET with ICSI where the HOS test was < 50% according to deciles of subnormal percentage motility (< 50%) and compared to those with normal motility > or = 50%.

Results: The combination of very poor motility and low HOS test scores did diminish pregnancy rates following IVF with ICSI.

Gonadotropinoma presenting as a case of pseudo-ovarian failure changing to macroprolactinoma.

Purpose: To present the first gonadotropinoma presenting as pseudo-menopause in a teenager.

Methods: Human menopausal gonadotropins (hMG) were given to a 37-year-old woman whose hypergonadotropic amenorrhea with estrogen deficiency as a teenager was changed to hypogonadotropic amenorrhea by the growth and prolactin secretion of a macroprolactinoma.

Results: The patient responded multiple times, and every time to stimulation with hMG and each time produced several dominant follicles.

The use of sympathomimetic amines for the treatment of severe constipation refractory to conventional therapy--case report.

Purpose: Sympathetic nervous system hypofunction has been found to be associated with motility disorders of the bowel, including gastroparesis, pseudointestinal obstruction, and esophageal motility disorders. These disorders respond to sympathomimetic amine therapy. The purpose of this study was to see if this therapy could be effective in treating pathological constipation.

Sympathomimetic amines effectively control pain for interstitial cystitis that had not responded to other therapies.

Purpose: To further investigate the efficacy of treatment of interstitial cystitis that had been refractory to standard treatment with sympathomimetic amines.

Methods: Dextroamphetamine sulfate sustained release capsules up to 30 mg per day were prescribed in women with refractory painful bladder syndrome/interstitial cystitis in six new cases. The patients were carefully evaluated for relief of symptoms.

Low hypo-osmotic swelling tests correlate with low percent motility and age of the male.

Purpose: To determine if sperm motility and hypo-osmotic swelling (HOS) test scores are associated. Furthermore the study would determine if the chance of having a subnormal HOS test increases as motility levels decrease. Finally the study would determine if age, motility, and HOS test scores are independent factors or if they interact.

Younger women with diminished oocyte reserve are not more prone to meiosis errors leading to spontaneous abortion than their age peers with normal oocyte reserve.

Purpose: To determine the relative effect of age vs ovarian oocyte reserve on miscarriage rates.

Materials And Methods: Miscarriage rates (loss of pregnancy established by ultrasound) from pregnancies achieved through in vitro fertilization-embryo transfer (IVF-ET) were evaluated according to four age groups (< or = 35, 36-39, 40-42, and 43-44 years) and four day 3 serum follicle-stimulating hormone (FSH) groups (< or = 11, 12-14, 15-17, and > 17 mIU/ml). All cycles were supplemented with progesterone in the luteal phase.

Intracytoplasmic sperm injection allows normal pregnancy rates for males 40 with low hypoosmotic swelling test scores even when complicated by very low motility percentage.

Purpose: To determine if the additional burden of low percentage motility reduces the chance that sperm with low hypoosmotic swelling (HOS) test scores will achieve a pregnancy following in vitro fertilization (IVF) with intracytoplasmic sperm injections (ICSI).

Methods: Couples undergoing IVF-embryo transfer (ET) and ICSI for low HOS tests (< 50%) were retrospectively identified. The percentage motility was divided into deciles.

Isolating sperm by selecting those with normal nuclear morphology prior to intracytoplasmic sperm injection (ICSI) does not provide better pregnancy rates compared to conventional ICSI in women with repeated conception failure with in vitro fertilization.

Purpose: To determine if isolation of sperm by nuclear characteristics using high magnification offers any advantage over the normal morphologic methods when performing intracytoplasmic sperm injection (ICSI) in refractory cases in which the male partner had an abnormal DNA fragmentation index.

Materials And Methods: Women aged < or = 39 with failure to have a successful conception after three consecutive embryo transfers whose male partner had a DNA fragmentation index > 30% were randomly assigned to isolation of sperm for ICSI by a new high magnification procedure to evaluate nuclear morphology and the usual method with normal magnification where nuclear characteristics were not seen. Women 40-43 were not randomized and were given the option after hearing pros and cons.

The interrelationship of sleep, biologic clocks, neurotransmitters, gonadotropins and pubertal development.

Purpose: To evaluate the influence of sleep on early pre-pubertal and pubertal development and to explore the importance of circadian rhythms and gonadotropin secretion.

Methods: Mechanisms of suppression and turning on of the hypothalamic gonadotropin releasing hormone (GnRH) pulse generator at different times in development are evaluated. Furthermore, the influence of neurotransmitters in controlling pubertal development is also considered.

The sharing of eggs by infertile women who are trying to conceive themselves with an egg recipient for financial advantages does not jeopardize the donor's chance of conceiving.

Purpose: To determine if the sharing of oocytes by an infertile woman with an egg recipient for financial advantages has any negative impact on the success rate for the donor.

Methods: A matched controlled study was performed comparing pregnancy outcome of women undergoing in vitro fertilization-embryo transfer (IVF-ET) but sharing half of their eggs with a recipient vs women undergoing IVF-ET but not sharing oocytes.

Results: Even though more women sharing oocytes deferred fresh transfer and cryopreserved the embryos because of a greater likelihood of ovarian hyperstimulation syndrome, there was no difference in pregnancy rates between the two groups after their first embryo transfer whether it was with fresh or frozen-thawed embryos.

No evidence to support the concept that low serum dehydroepiandrosterone (DHEA) sulfate (s) levels are associated with less oocyte production or lower pregnancy rates.

Purpose: To determine if in a population of women with diminished oocyte reserve as evidenced by day 3 serum follicle stimulating hormone (FSH) levels > 12 mIU/ml women with lower dehydroepiandrosterone sulfate (DHEA-s) levels produce fewer oocytes or have lower pregnancy rates following in vitro fertilization-embryo transfer (IVF-ET) compared to women with higher levels.

Methods: The women were divided into poor responders (producing < or = 4 oocytes) following oocyte retrieval or good responders (> or = 5 oocytes). Mean DHEA-s levels were compared in poor vs good responders and in the subgroups of those who conceived vs those who did not conceive.

Secondary amenorrhea despite normal endometrial development with secretory changes and absence of uterine synechiae -- a second case of the endometrial compaction-apoptosis syndrome.

Purpose: To report the second case of amenorrhea related to endometrial compaction apoptosis syndrome.

Materials And Methods: A female with secondary amenorrhea was evaluated with sonography, hysteroscopy, serum estradiol and progesterone levels, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), and endometrial biopsy.

Results: Initially she was found to be ovulatory.

Prevention of first-trimester miscarriage with dextroamphetamine sulfate treatment in women with recurrent miscarriage following embryo transfer -- case report.

Purpose: To present a novel approach to prevent miscarriage by treatment with sympathomimetic amines.

Materials And Methods: Two women undergoing in vitro fertilization-embryo transfer (IVF-ET) with a history of recurrent miscarriage even in IVF-ET cycles were treated with dextroamphetamine sulfate prior to their next IVF-ET cycles.

Results: Both women successfully completed their first trimester.

Contemporary Diagnostic Strategies for the Detection of Helicobacter pylori Infection.

Helicobacter pylori infection is highly prevalent, affecting approximately half of the world's population. While the majority of infected individuals are asymptomatic, H. pylori infection is associated with certain diseases, including peptic ulcers (either duodenal or gastric), gastritis, and 2 malignancies-gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma.

Levamisole-induced Wegener's granulomatosis following contaminated cocaine abuse.

A 44-year-old woman with a medical history of chronic pain syndrome presented with a 3-day history of a painful "rash" that started on her face and spread to her legs. Further history revealed that she recently started a new medication, varenicline, 7 weeks prior to admission and had a long-standing history of intranasal cocaine use. Review of systems was significant for rhinitis, nasal congestion, joint pain, and a febrile episode 2 days prior to admission.

Pregnancy outcome following in vitro fertilization-embryo transfer according to the percentage of metaphase II oocytes retrieved.

Purpose: To determine if the presence of a lower percentage of metaphase II eggs during oocyte retrieval leads to a lower fertilization rate of these metaphase II eggs since they may be more likely to be not quite fully mature, and to determine if transfer of embryos made from these eggs leads to lower pregnancy and implantation rates.

Methods: Fertilization and pregnancy rates determined according to deciles of percent of metaphase II eggs beginning with <30%.

Results: Though there was no difference in fertilization rates when comparing those with <60% metaphase II eggs vs a 60%, there were significantly higher clinical and live delivered pregnancy rates and implantation rates when there were a 60% of the eggs retrieved that were metaphase II.

Pregnancy rates following frozen embryo transfer (ET) in women failing to conceive despite fresh ET in women using low dosage follicle stimulating hormone (FSH) protocol for follicular maturation of several eggs.

Purpose: To determine the pregnancy rate following frozen embryo transfer using embryos derived from low dosage follicle stimulating hormone (FSH) stimulation protocols in women aged < 42 who did not have diminished egg reserve as evidenced by a day 3 serum FSH < or =12 mIU/ml.

Methods: A retrospective review was performed evaluating pregnancy rates on frozen embryo transfers from women who usually had diminished egg reserve and thus used no more than 150 IU of FSH. The pregnancy rates were calculated on the first frozen embryo transfer of women failing to successfully conceive on the fresh embryo transfer.

Low hypoosmotic swelling test scores correlate better with lower percent motility than any other abnormal semen parameters.

Purpose: To determine if any single abnormal semen parameter is associated with low hypoosmotic swelling (HOS) test scores.

Methods: A retrospective review evaluating males with single sperm defects of sperm concentration, % progressive motility, morphology using strict criteria, and antisperm antibodies. The percentage of these males with HOS test scores < 50% was then determined.

Intracytoplasmic sperm injection completely negates the implantation problem associated with conventional fertilization with sperm with low hypo-osmotic swelling test scores as evidenced by evaluating donor-recipient pairs.

Purpose: To corroborate or refute the claim that intracytoplasmic sperm injection (ICSI) can overcome the problem found after conventional insemination of oocytes with sperm with low hypoosmotic swelling (HOS) tests of forming embryos with low implantation potential.

Methods: Matched couple pairs sharing one pool of oocytes were identified where one of the male partners had a low HOS test score and the other one with a normal one. Intracytoplasmic sperm injection was always used in those with low HOS test scores (i.

Frequency of subnormal hypoosmotic swelling tests increase with advancing age of the male.

Purpose: To determine if there is an increased frequency of abnormal hypoosmotic swelling (HOS) tests when testing semen in males of advanced reproductive age.

Methods: Ten-year retrospective review according to six age groups (< or = 29.9, 30-34.

"Embryo glue" does not seem to improve chances of subsequent pregnancy in refractory in vitro fertilization cases.

Purpose: To determine if the use of Embryo glue improves implantation and pregnancy rates following embryo transfer (ET) in women who failed to conceive in three previous attempts.

Methods: A matched controlled study was performed in women undergoing IVF-ET, donor oocyte recipients and women using their own oocytes having fresh or frozen ETs. A woman having Embryo glue was matched with the very next woman not using glue within six months of age and having the same number of previous failed ETs.