Uterine artery Doppler in the management of early pregnancy loss: a prospective, longitudinal study.

Background: The pharmacological management of early pregnancy loss reduced substantially the need for dilation and curettage. However, prognostic markers of successful outcome were not established. Thus the major purpose of this study was to determine the sensitivity and specificity of the uterine artery pulsatility (PI) and resistance (RI) indices to detect early pregnancy loss patients requiring dilation and curettage after unsuccessful management.

Inflammatory and cardiometabolic risk on obesity: role of environmental xenoestrogens.

Context: Some chemicals used in consumer products or manufacturing (eg, plastics, pesticides) have estrogenic activities; these xenoestrogens (XEs) may affect immune responses and have recently emerged as a new risk factors for obesity and cardiovascular disease. However, the extent and impact on health of chronic exposure of the general population to XEs are still unknown.

Objective: The objective of the study was to investigate the levels of XEs in plasma and adipose tissue (AT) depots in a sample of pre- and postmenopausal obese women undergoing bariatric surgery and their cardiometabolic impact in an obese state.

Lowered national cesarean section rates after a concerted action.

Objective: To evaluate national cesarean section (CS) rates and other obstetric indicators after a concerted action to reduce CS rates was undertaken in Portugal from 2010 onwards. This action was based on the transmission of information and training of healthcare professionals, together with the inclusion of CS rates as a criterion for hospital funding.

Design: Retrospective observational population-based study.

The TRIBECA study: (TRI)fecta (B)ioprosthesis (E)valuation versus (C)arpentier Magna-Ease in (A)ortic position.

Objective: To determine whether the Trifecta bioprosthetic aortic valve produces postoperative haemodynamic results comparable with or better than those of the Magna Ease aortic valve bioprosthesis.

Methods: We retrospectively reviewed the medical records of patients who had undergone aortic valve replacement with Trifecta or Magna Ease prostheses at eight European institutions between January 2011 and May 2013, and analysed early postoperative haemodynamic performance by means of echocardiography.

Results: A total of 791 patients underwent aortic valve replacement (469 Magna Ease, 322 Trifecta).

Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients.

Background: Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality.

Objective: This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers. Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake.

Effect of a natural mineral-rich water on catechol-O-methyltransferase function.

Catechol-O-methyltransferase (COMT) is a magnesium-dependent, catecholamine-metabolizing enzyme, whose impaired activity has been positively associated with cardiovascular diseases, particularly hypertension. Consumption of some natural mineral-rich waters has been shown to exert protective effects on cardiovascular risk factors, eg. by decreasing arterial blood pressure and blood lipids.

Obesity and the challenges of caesarean delivery: prevention and management of wound complications.

Caesarean section in obese patients is associated with an increased risk of surgical wound complications, including haematoma, seroma, abscess and dehiscence. This review focusses on the available strategies to decrease wound complications in this population, and on the clinical management of these situations. Appropriate dose of prophylactic antibiotics, closure of the subcutaneous tissue, and avoidance of subcutaneous drains reduce the incidence of wound complications associated with caesarean section in obese patients.

Acute transient myopia with shallowing of the anterior chamber induced by sulfamethoxazole in a patient with pseudoxanthoma elasticum.

Purpose: To report a case of acute transient myopia with anterior chamber shallowing induced by sulfamethoxazole in a patient with pseudoxanthoma elasticum (PXE).

Design: Observational case report.

Methods: A case report of a 45-year-old woman who presented with bilateral acute myopia, anterior chamber shallowing, and intraocular hypertension induced by sulfamethoxazole and was found to have PXE.

Persistent organic pollutant levels in human visceral and subcutaneous adipose tissue in obese individuals--depot differences and dysmetabolism implications.

Background: The role of persistent organic pollutants (POPs) with endocrine disrupting activity in the aetiology of obesity and other metabolic dysfunctions has been recently highlighted. Adipose tissue (AT) is a common site of POPs accumulation where they can induce adverse effects on human health.

Objectives: To evaluate the presence of POPs in human visceral (vAT) and subcutaneous (scAT) adipose tissue in a sample of Portuguese obese patients that underwent bariatric surgery, and assess their putative association with metabolic disruption preoperatively, as well as with subsequent body mass index (BMI) reduction.

Can the adrenergic system be implicated in the pathophysiology of bladder pain syndrome/interstitial cystitis? A clinical and experimental study.

Aims: To evaluate sympathetic system activity in bladder pain syndrome/interstitial cystitis (BPS/IC) patients and to investigate if chronic adrenergic stimulation in intact rats induces BPS/IC-like bladder modifications.

Methods: Clinical study--In BPS/IC patients and aged and body mass index matched volunteers TILT test was undertaken and catecholamines were measured in plasma and 24 hr urine samples. Experimental study--Phenylephrine was injected subcutaneously (14 days) to female Wistar rats.

The HIF1A functional genetic polymorphism at locus +1772 associates with progression to metastatic prostate cancer and refractoriness to hormonal castration.

The hypoxia inducible factor 1 alpha (HIF1a) is a key regulator of tumour cell response to hypoxia, orchestrating mechanisms known to be involved in cancer aggressiveness and metastatic behaviour. In this study we sought to evaluate the association of a functional genetic polymorphism in HIF1A with overall and metastatic prostate cancer (PCa) risk and with response to androgen deprivation therapy (ADT). The HIF1A +1772 C>T (rs11549465) polymorphism was genotyped, using DNA isolated from peripheral blood, in 1490 male subjects (754 with prostate cancer and 736 controls cancer-free) through Real-Time PCR.

Can serum angiogenin be used to improve the diagnostic performance in prostate cancer screening?

Several biomarkers have been studied to avoid unnecessary biopsies resulting from suboptimal performance of prostate-specific antigen (PSA) testing. We aimed to assess the use of serum angiogenin as a prostate cancer diagnostic tool among candidates for biopsy. We selected 252 patients referred for ultrasound-guided transrectal prostate biopsy on the basis of an abnormal digital rectal examination and/or elevated total PSA.

Inverted left atrial appendage bonded to atrial septum.

Inverted left atrial appendage (LAA) is a rare surgical complication. Our patient, a boy aged 2 years, was diagnosed with a partial atrioventricular defect with mild regurgitation of the left atrioventricular valve and a large primum atrial septal defect. Direct postoperative transesophageal echocardiography revealed a new left atrial mass attached to the atrial septum, without left ventricle inflow obstruction.

Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review.

Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser.

Dilated fourth ventricle in fetuses with trisomy 18, trisomy 13 and triploidy at 11-13 weeks' gestation.

Objective: To determine if in fetuses with aneuploidies the diameter of the fourth cerebral ventricle at 11-13 weeks' gestation is different from euploid fetuses.

Methods: The fourth ventricle at 11-13 weeks' gestation was assessed in 62 cases of trisomy 21, 32 of trisomy 18, 10 of trisomy 13, and 12 of triploidy and compared to 410 normal euploid fetuses. Transvaginal sonography was carried out and 3D brain volumes were acquired.

Lateral ventricles in fetuses with aneuploidies at 11-13 weeks' gestation.

Objective: To examine the possible association between aneuploidies and fetal lateral cerebral ventriculomegaly in the first trimester of pregnancy.

Methods: Three-dimensional brain volumes were acquired by transvaginal ultrasound examination at 11-13 weeks' gestation in 410 euploid fetuses and 63 fetuses with trisomy 21, 34 with trisomy 18 and seven with trisomy 13. Lateral ventricles were assessed in a transverse view, just above the roof of the third ventricle and measurements of the areas of the lateral ventricles and choroid plexuses were obtained.

Does baseline total testosterone improve the yielding of prostate cancer screening?

Previous studies suggest an association between total testosterone (tT) and prostate cancer, but results are conflicting and it is not clear if accounting for the tT levels improves the yielding of patient selection for prostatic biopsy. We evaluated the potential for tT levels and the tT/total PSA (tPSA) ratio to be used as diagnostic tools for prostate cancer and its relation with cancer aggressiveness. We measured tT, tPSA and free PSA (fPSA) in fasting blood samples of 1570 subjects consecutively referred for prostate biopsy due to abnormal digital rectal examination and/or elevated tPSA levels.

Predictive factors of a successful testicular biopsy and subsequent clinical pregnancy.

Forecast of success with testicular sperm extraction and intracytoplasmic sperm injection (ICSI) remains unknown, as predictive factors have rarely been studied. We evaluated the association among possible predictive factors and a successful biopsy and clinical pregnancy. A consecutive sample of men submitted to a testicular open biopsy in S.

Cerebral ventricular system in fetuses with open spina bifida at 11-13 weeks' gestation.

Objective: To determine if in fetuses with open spina bifida at 11-13 weeks' gestation there are alterations in the cerebral ventricular system.

Methods: In this study we selected 10 cases of open spina bifida and 410 normal singleton pregnancies which subsequently resulted in the delivery of phenotypically normal neonates. In all cases transvaginal sonography was carried out at 11-13 weeks' gestation and three-dimensional (3D) brain volumes were acquired.

Sustaining simulation training programmes--experience from maternity care.

There is little scientific evidence to support the majority of simulation-based maternity training programmes, but some characteristics appear to be associated with sustainability. Among these are a clear institutional-level commitment to the course, strong leadership in course organisation, a curriculum relevant to clinical practice, a nonthreatening learning environment, the establishment of multiprofessional training and the use of simulators appropriate to the learning objectives. There is still some debate on whether simulation-based sessions should be carried out in dedicated training time outside normal working hours or in ad-hoc drills that are run during clinical sessions, whether they should be located in clinical areas, simulation centres, or both, and whether or not they should include standardised generic teamwork training sessions.

High effectiveness of pandemic influenza A (H1N1) vaccination in healthcare workers from a Portuguese hospital.

Objectives: Vaccination of healthcare workers (HCWs) was made a high priority during the phase six pandemic of the novel influenza A H1N1 (pH1N1) virus. We surveyed adherence to pH1N1 vaccination and the incidence of pH1N1 infection between vaccinated and unvaccinated HCWs.

Methods: Employees at the S.