Oesophageal duplication cyst: an unusual cause of retrosternal pain and dysphagia in an adult

Oesophageal duplication cysts in adults are a rare entity and are mostly asymptomatic. We describe the imaging findings in a rare case of oesophageal duplication cyst simulating cold abscess, causing retrosternal pain and dysphagia in a 25-year-old man.     

Lack of bioequivalence between two aciclovir tablets in healthy subjects

OBJECTIVE: This study aimed to compare the systemic bioavailability of two aciclovir tablets, Rouz-Aciclovir (test) and Zovirax (reference), in 12 healthy volunteers. METHODS: In a crossover design, each subject received a single oral dose of aciclovir 400 mg followed by a 7-day washout period. Plasma concentrations of aciclovir were measured for up to 12 hours using a validated high-performance liquid chromatography method with a lower limit of quantification of 50 microg/L. RESULTS: The mean values of maximum plasma concentration (C(max)), time to C(max) (t(max)), area under the plasma concentration-time curve from time 0 to 12 hours (AUC(12)) and from time 0 to infinity (AUC(infinity)), and plasma half-life following administration of the test product were 999.6 microg/L, 2.08 h, 4911.2 microg/L . h, 5417.7 microg/L . h and 3.08 h, respectively, and for the reference product 775.8 microg/L, 2.58 h, 3862.1 microg/L . h, 4295.4 microg/L . h and 3.14 h, respectively. The test/reference geometric ratio for C(max) (90% CI) was 1.30 (97.1, 174.8). The test/reference geometric ratios for AUC(12) (90% CI) and AUC(infinity) (90% CI) were 1.26 (99.7, 159.1) and 1.24 (98.9, 155.6), respectively. Therefore, the 90% CIs of C(max), AUC(12) and AUC(infinity) were not within the acceptable range of 80 and 125 suggested by the US FDA bioequivalence guideline. CONCLUSION: The results of the present study suggest that the aciclovir test product was not bioequivalent to the reference product. The exact reasons for this remain to be determined. However, we think the difference should be attributed to the difference in the type and amounts of ingredients used in the formulation that probably affect the contact time of aciclovir with the sites of absorption in the gut.     

Firework-Related Injuries in Tehran's Persian Wednesday Eve Festival (Chaharshanbe Soori)

Background: Fireworks are the leading cause of injuries such as burns and amputations during the Persian Wednesday Eve Festival (Chaharshanbeh Soori). Objectives: This study was designed to explore the age of the high-risk population, the type of fireworks most frequently causing injury, the pattern of injury, and the frequency of permanent disabilities. Methods: This cohort study was performed by Tehran Emergency Medical Services at different medical centers all around Tehran, Iran, in individuals referred due to firework-related injuries during 1 month surrounding the festival in the year 2007. The following information was extracted from the patients' medical records: demographic data, the type of fireworks causing injury, the pattern and severity of the injury, the pre-hospital and hospital care provided for the patient, and the patient's condition at the time of discharge. In addition, information on the severity of the remaining disability was recorded 8 months after the injury. Results: There were 197 patients enrolled in the study with a mean age of 20.94 ± 11.31 years; the majority of them were male. Fuse-detonated noisemakers and homemade grenades were the most frequent causes of injury. Hand injury was reported in 39.8% of the cases. Amputation and long-term disability were found in 6 and 12 cases, respectively. None of the patients died during the study period. Conclusion: The fireworks used during a Chaharshanbe Soori ceremony were responsible for a considerable number of injuries to different parts of the body, and some of them led to permanent disabilities.     

Birthweight in infants conceived through in vitro fertilization following blastocyst or cleavage-stage embryo transfer: a national registry study

Purpose

In vitro fertilization (IVF) infants have lower birthweights than their peers, predisposing them to long-term health consequences. Blastocyst transfer (BT), at day 5–6 post-fertilization, is increasing in usage, partially due to improved pregnancy outcomes over cleavage-stage transfer (CT, day 2–3). Data to date, however, have been inconclusive regarding BT’s effects on birthweight.

Methods

Participants included all US autologous, single-gestation, fresh embryo transfer cycles initiated from 2007 to 2014 that resulted in a term infant (N?=?124,154) from the National Assisted Reproductive Technology Surveillance System. Generalized linear models including obstetric history, maternal demographics, and infant sex and gestational age were used to compare birthweight outcomes for infants born following BT (N?=?67,169) with infants born following CT (N?=?56,985) and to test for an interaction between transfer stage and single embryo transfer (SET).

Results

Infants born following BT were 6 g larger than those born following CT (p?=?0.04), but rates of macrosomia (RR 1.00, 95% CI 0.96–1.04) and low birthweight (LBW, RR 1.00, 95% CI 0.93–1.06) were not different between the groups. The interaction between SET and transfer stage was significant (p?=?0.02). Among SET infants, BT was associated with 19.26 g increased birthweight compared to CT (p?=?0.008).

Conclusions

The increase in birthweights identified following BT is unlikely to be clinically relevant, as there were no differences in rates of macrosomia or LBW. These findings are clinically reassuring and indicate that the increasing use of BT is unlikely to further decrease the on average lower birthweights seen in IVF infants compared to their naturally conceived peers.

     

Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of imaging in the management of progressive glioblastoma in adults

Journal of Neuro-Oncology - These recommendations apply to adults with glioblastoma who have been previously treated with first-line radiation or chemoradiotherapy and who are suspected of...     

Ovulation induction and intrauterine insemination in women of advanced reproductive age: a systematic review of the literature

Journal of Assisted Reproduction and Genetics - The objective of this review is to define live birth rate (LBR) and clinical pregnancy rate (CPR) for women?≥?40 undergoing...     

THE FIRST SUCCESSFUL PREGNANCY FOLLOWING INJECTION OF TESTICULAR ROUND SPERMATID IN IRAN

The authors report the healthy delivery of the first successful round spermatid injection in Iran. The male was a 40-year-old with nonobstructive azoospermia whose previous testicular biopsy revealed only round spermatids. The wife was a 29-year-old healthy woman.