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https://www.readbyqxmd.com/read/28163428/pediatric-cardiovascular-care-in-uganda-current-status-challenges-and-opportunities-for-the-future
#1
Twalib Olega Aliku, Sulaiman Lubega, Judith Namuyonga, Tom Mwambu, Michael Oketcho, John O Omagino, Craig Sable, Peter Lwabi
In many developing countries, concerted action against common childhood infectious diseases has resulted in remarkable reduction in infant and under-five mortality. As a result, pediatric cardiovascular diseases are emerging as a major contributor to childhood morbidity and mortality. Pediatric cardiac surgery and cardiac catheterization interventions are available in only a few of Sub-Saharan African countries. In Uganda, open heart surgeries (OHSs) and interventional procedures for pediatric cardiovascular disease are only possible at the Uganda Heart Institute (UHI), having been started with the help of expatriate teams from the years 2007 and 2012, respectively...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28137754/efficacy-and-safety-of-follitropin-alfa-lutropin-alfa-in-art-a-randomized-controlled-trial-in-poor-ovarian-responders
#2
P Humaidan, W Chin, D Rogoff, T D'Hooghe, S Longobardi, J Hubbard, J Schertz
STUDY QUESTION: How does the efficacy and safety of a fixed-ratio combination of recombinant human FSH plus recombinant human LH (follitropin alfa plus lutropin alfa; r-hFSH/r-hLH) compare with that of r-hFSH monotherapy for controlled ovarian stimulation (COS) in patients with poor ovarian response (POR)? SUMMARY ANSWER: The primary and secondary efficacy endpoints were comparable between treatment groups and the safety profile of both treatment regimens was favourable...
January 30, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28118681/metformin-during-ovulation-induction-with-gonadotrophins-followed-by-timed-intercourse-or-intrauterine-insemination-for-subfertility-associated-with-polycystic-ovary-syndrome
#3
REVIEW
Esmée M Bordewijk, Marleen Nahuis, Michael F Costello, Fulco Van der Veen, Leopoldo O Tso, Ben Willem J Mol, Madelon van Wely
BACKGROUND: Clomiphene citrate (CC) is generally considered first-line treatment in women with anovulation due to polycystic ovary syndrome (PCOS). Ovulation induction with follicle-stimulating hormone (FSH; gonadotrophins) is second-line treatment for women who do not ovulate or conceive while taking CC. Metformin may increase the effectiveness of ovulation induction with gonadotrophins and may promote safety by preventing multiple pregnancy. OBJECTIVES: To determine the effectiveness and safety of metformin co-treatment during ovulation induction with gonadotrophins with respect to rates of live birth and multiple pregnancy in women with PCOS...
January 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28111738/interventions-for-the-prevention-of-ohss-in-art-cycles-an-overview-of-cochrane-reviews
#4
REVIEW
Selma Mourad, Julie Brown, Cindy Farquhar
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technology (ART) cycles is a treatment-induced disease that has an estimated prevalence of 20% to 33% in its mild form and 3% to 8% in its moderate or severe form. These numbers might even be higher for high-risk women such as those with polycystic ovaries or a high oocyte yield from ovum pickup. OBJECTIVES: The objective of this overview is to identify and summarise all evidence from Cochrane systematic reviews on interventions for prevention or treatment of moderate, severe and overall OHSS in couples with subfertility who are undergoing ART cycles...
January 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28077366/effectiveness-of-acupuncture-in-women-with-polycystic-ovarian-syndrome-undergoing-in-vitro-fertilisation-or-intracytoplasmic-sperm-injection-a-systematic-review-and-meta-analysis
#5
Junyoung Jo, Yoon Jae Lee
OBJECTIVES: The aim of this systematic review was to assess the evidence from randomised controlled trials (RCTs) on the efficacy, effectiveness and safety of acupuncture in women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). METHODS: We searched a total of 15 databases through October 2015. The participants were women with PCOS (diagnosed using the Rotterdam criteria) undergoing IVF or ICSI...
January 11, 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/28056210/cooperation-between-occupational-health-services-and-small-scale-enterprises-in-norway-and-sweden
#6
Stig Vinberg, Lisa Torsdatter Markussen, Bodil J Landstad
Although small-scale enterprises (SSEs) dominate the private enterprise sector, knowledge about support for these organizations from occupational health services (OHSs) is insufficient. The aim of this research was to study OHS services provided and staff cooperation with SSEs in Norway and Sweden. In total, 87 Norwegian and 51 Swedish OHS providers answered a survey on their experiences providing requested services from and cooperation with SSEs. Based on survey questions and constructed indices, providers in the two countries were compared using independent sample t tests and non-parametric tests...
December 1, 2016: Workplace Health & Safety
https://www.readbyqxmd.com/read/28050961/final-oocyte-maturation-in-assisted-reproduction-with-human-chorionic-gonadotropin-and-gonadotropin-releasing-hormone-agonist-dual-trigger
#7
REVIEW
Sofia Andrade de Oliveira, Vinícius Fernando Calsavara, Gemma Castillón Cortés
Final oocyte maturation with Human Chorionic Gonadotropin (hCG) and ovarian stimulation with Follicle Stimulation Hormone (FSH) combined with Gonadotrophin-releasing Hormone (GnRH) antagonist to block Luteinizing hormone (LH) surge is a standard procedure of in vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI). However, GnRH agonist has been replacing the use of hCG in certain situations, especially in patients at risk of Ovarian Hyperstimulation Syndrome (OHSS). Some studies have also shown advantages in the combined use of GnRH agonist concurrently with hCG in inducing final oocyte maturation, a treatment known as "Dual Trigger"...
December 1, 2016: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/28029396/standards-of-care-in-infertility-in-europe
#8
REVIEW
Christina I Messini, Alexandros Daponte, George Anifandis, Tahir Mahmood, Ioannis E Messinis
Evidence-based medicine is the principal approach to medical practice. There are several debatable issues in infertility, which require clarification. Over the past 20 years, reliable methodology has been developed for the management of infertile couples. This includes high quality diagnostic and therapeutic procedures, which are applied in highly specialised infertility centres. The European Board and College of Obstetrics and Gynaecology (EBCOG) has published Standards of Care for Women's Health in Europe, which should be the cornerstone for the clinicians and service providers in the European Union to establish common protocols within their centres...
October 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28019139/individual-luteolysis-post-gnrh-agonist-trigger-in-gnrh-antagonist-protocols
#9
B Lawrenz, F Ruiz, N Engelmann, H M Fatemi
Over the past few years, the use of Gonadotropin-releasing-hormone (GnRH)-agonist for final oocyte maturation in GnRH-antagonist-protocols in stimulated IVF/ICSI cycles has gained worldwide acceptance, as this approach reduces significantly the risk for development of ovarian hyperstimulation syndrome (OHSS). Final oocyte maturation with GnRH-agonist leads to sever luteolysis, which cannot be counterbalanced using standard luteal phase support with purely progesterone (P4) application and therefore administration of hCG or high doses of P4 is considered to be essential to prevent/counteract luteolysis...
December 26, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27998636/use-of-point-of-care-ultrasound-for-the-diagnosis-of-ovarian-hyperstimulation-syndrome
#10
Sowdhamani Bellapu, Joshua Guttman
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) occurs when ovaries are overstimulated and enlarged due to fertility treatments resulting in a shift of serum from the intravascular space to the third space, mainly the abdominal cavity. It is the most serious complication of ovarian hyperstimulation for assisted reproduction. CASE REPORT: We present the case of a 40-year-old woman who presented with abdominal bloating and nausea 2 weeks after undergoing in vitro fertilization (IVF); she was diagnosed by an outside radiology ultrasound as having a ruptured ovarian cyst...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27978775/can-amh-levels-predict-the-need-for-increased-medication-during-ivf-icsi-in-pcos-women
#11
Ahmed Kamel, Wafaa Ramadan, Ahmed M Hussein, Sherif Dahab, Moutaz M Elsherbini, Yossra S Lasheen, Fouad Abu-Hamila
PURPOSE: To investigate the ability of anti-Mullerian hormone (AMH) to predict the step up of human menopausal gonadotropins (HMG) dose in women with polycystic ovarian syndrome (PCOS) undergoing IVF/ICSI cycles. METHODS: AMH was drawn before ovulation induction in 976 PCOS women scheduled for IVF/ICSI. After all cycles ended, a receiver operating characteristic (ROC) curve analysis was done to investigate the ability of AMH to predict step up of the HMG. RESULTS: The area under the curve (AUC) was 0...
January 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27976369/clomiphene-and-other-antioestrogens-for-ovulation-induction-in-polycystic-ovarian-syndrome
#12
REVIEW
Julie Brown, Cindy Farquhar
BACKGROUND: Subfertility due to anovulation is a common problem in women. First-line oral treatment is with antioestrogens such as clomiphene citrate, but resistance may be apparent with clomiphene. Alternative and adjunctive treatments have been used including tamoxifen, dexamethasone, and bromocriptine. The effectiveness of these is to be determined. OBJECTIVES: To determine the relative effectiveness of antioestrogen agents including clomiphene alone or in combination with other medical therapies in women with subfertility associated with anovulation, possibly caused by polycystic ovarian syndrome...
15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27976360/day-three-versus-day-two-embryo-transfer-following-in-vitro-fertilization-or-intracytoplasmic-sperm-injection
#13
REVIEW
Julie Brown, Salim Daya, Phill Matson
BACKGROUND: Embryo transfer (ET) was traditionally performed two days after oocyte retrieval; however, developments in culture media have allowed embryos to be maintained in culture for longer periods. Delaying transfer from Day two to Day three would allow for further development of the embryo and might have a positive effect on pregnancy outcomes. OBJECTIVES: To determine if there are any differences in live birth and pregnancy rates when embryo transfer is performed on day three after oocyte retrieval, compared with day two, in infertile couples undergoing treatment with in vitro fertilisation (IVF), including intracytoplasmic sperm injection (ICSI)...
14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27901279/dopamine-agonists-for-preventing-ovarian-hyperstimulation-syndrome
#14
REVIEW
Huilin Tang, Selma Mourad, Suo-Di Zhai, Roger J Hart
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). It is characterised by enlarged ovaries and an acute fluid shift from the intravascular space to the third space, resulting in bloating, increased risk of venous thromboembolism and decreased organ perfusion. Most cases are mild, but forms of moderate or severe OHSS appear in 3% to 8% of in vitro fertilisation (IVF) cycles. The dopamine agonist cabergoline was introduced as a secondary prevention intervention for OHSS in women at high risk of OHSS undergoing ART treatment...
30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27884883/bilateral-ureteric-obstruction-during-in-vitro-fertilisation-therapy-in-a-patient-with-complex-surgically-managed-crohn-s-disease
#15
Christopher Charles Khoo, Nikhil Ahluwalia, Jan Grace, Arun Sahai
A 37-year-old woman receiving in vitro fertilisation (IVF) treatment presented with lethargy, fevers and anuria. Her background included complex surgically managed Crohn's disease and mild right-sided hydronephrosis (with no evidence of obstruction on MAG3 renogram). On examination, she had a distended abdomen with generalised tenderness. Blood tests revealed an acute kidney injury and confirmed sepsis. She was found to have bilateral ureteric obstruction with worsening of the right-sided hydronephrosis and new-onset left-sided hydronephrosis secondary to bilateral ovarian masses, diagnosed as mild ovarian hyperstimulation syndrome (OHSS)...
November 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27865939/c-reactive-protein-response-is-higher-in-early-than-in-late-ovarian-hyperstimulation-syndrome
#16
Kati V M Korhonen, Hanna M Savolainen-Peltonen, Tomi S Mikkola, Aila E Tiitinen, Leila S Unkila-Kallio
OBJECTIVES: Many in vitro fertilization (IVF) complications are inflammatory by nature, some of which are even life-threatening. We evaluated the response of C-reactive protein (CRP) in IVF complications, especially in early and late ovarian hyperstimulation syndrome (OHSS), to support clinical decision making in gynecological emergency policlinics. STUDY DESIGN: In a prospective two-year study at Helsinki University Hospital, Finland, we recruited patients with IVF complications including moderate or severe OHSS (n=47 patients: 36 early and 14 late OHSS cases), or other IVF complications (n=13)...
December 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27861970/internal-jugular-vein-thrombosis-with-ohss
#17
Seung Hyun Lee, Jung-Woo Park, Myoungseok Han, Jong Woon Bae, Yeon Jean Cho
Ovarian hyperstimulation syndrome (OHSS) includes ovarian enlargement and ascites. It is usually mild but can be, rarely, fatal. Deep vein thrombosis (DVT) is among the potentially fatal complications of OHSS. During pregnancy, DVT is more common in the lower extremities than in the upper part of the body, but OHSS-related DVT occurs more frequently in the upper part. Internal jugular vein thrombosis is considered rare, and duplex ultrasound is the appropriate examination for its diagnosis. We present a rare case of internal jugular vein thrombosis following OHSS...
November 10, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27852101/human-chorionic-gonadotrophin-priming-for-fertility-treatment-with-in-vitro-maturation
#18
REVIEW
Jane Reavey, Katy Vincent, Timothy Child, Ingrid E Granne
BACKGROUND: In vitro maturation (IVM) is a fertility treatment that involves the transvaginal retrieval of immature oocytes, and their subsequent maturation and fertilisation. Although the live birth rate is lower than conventional in vitro fertilisation (IVF) with ovarian stimulation, it is a useful treatment, as it avoids the risk of ovarian hyperstimulation syndrome (OHSS). Women with polycystic ovaries (PCO) or polycystic ovarian syndrome (PCOS) are at an increased risk of OHSS. Thus, IVM may be a more useful treatment in this patient group...
16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27821561/the-ovarian-renin-angiotensin-system-ovras-a-major-factor-in-ovarian-function-and-disease
#19
Angela Palumbo, Julio Ávila, Frederick Naftolin
This contribution summarizes the pivotal role of the ovarian renin-angiotensin system (OVRAS) in ovarian physiology and disease, with particular emphasis on human clinical implications and established translational applications. The presence of a complete OVRAS in all studied species has been known for decades. The OVRAS has major effects on follicle development/atresia and ovulation and steroid hormone secretion, that is, it is necessary for normal reproduction. It is well established that OVRAS activity is regulated by gonadotropins and depends on activation of proteases in the area of growing follicles...
December 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27816925/a-short-course-of-metformin-does-not-reduce-ohss-in-a-gnrh-antagonist-cycle-for-women-with-pcos-undergoing-ivf-a-randomised-placebo-controlled-trial
#20
S L Jacob, C Brewer, T Tang, H M Picton, J H Barth, A H Balen
STUDY QUESTION: Does 'metformin' reduce the incidence of ovarian hyperstimulation syndrome (OHSS) for women with polycystic ovary syndrome (PCOS) undergoing a GnRH antagonist assisted conception treatment cycle? SUMMARY ANSWER: A short course of metformin does not reduce the incidence of OHSS for women with PCOS undergoing a GnRH antagonist treatment cycle. WHAT IS KNOWN ALREADY: Metformin does reduce the incidence of OHSS in a GnRH-agonist treatment cycle...
November 5, 2016: Human Reproduction
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