The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization

To establish whether endometrial blood flow and thickness can predict the success rate of in-vitro fertilization, 156 cycles were evaluated. The parameters were: endometrial colour and power Doppler pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) and endometrial thickness. Each patient was studied: on the day of ovum retrievalpickup, and on the day of embryo transfer. Non-endometrial parameters studied were: age, oestrestrogen and progesterone concentrations, number of oocytes, and number of embryos. Pregnancy was achieved in 31 cycles. On the day of ovum retrieval, patients who conceived had PI, RI, and S/D values of 0.997, 0.563, and 2.403, respectively. Patients who did not conceive had values of 0.994, 0.584, and 2.477 respectively. The power Doppler technique provided similar results. On the day of embryo transfer, pregnant patients had PI, RI and S/D values of 1.096, 0.590 and, 2.597 respectively, while in the non-pregnant patients the values were 1.104, 0.603 and, 2.723 respectively. Power Doppler showed similar numbers. The differences between pregnant and non-pregnant patients were not statistically significant in any of the parameters. Endometrial thickness and blood flow does not seem to correlate with pregnancy rate in IVF.     

When should we give up on expectant management for patients with proximal ureteral stones?

Background:Proximal ureteral stones (PUS) have relatively low rates of spontaneous expulsion. However, some patients do well on expectant management. Our aim was to compare risk factors for surgical intervention in patients with PUS who underwent primary intervention to those subjected to expectant management.Materials and methods:We retrospectively reviewed the medical charts of patients presented to the emergency room with symptoms of renal colic and underwent computerized tomography between August 2016 and August 2017. A total of 97 consecutive patients were identified with up to 10mm PUS. We collected patient demographics, clinical, and imaging data, and performed binary regression analysis for risk of intervention.Results:The average age was 49years (range 17-97) and average stone size was 7.1mm (range 3-10). Forty-one patients underwent immediate intervention while the remaining 56 patients were treated conservatively. Of the 56 patients treated conservatively, 26 underwent delayed intervention while 30 reported spontaneous stone expulsion. On univariate analysis of all 97 patients, statistically significant risk factors for intervention were found based on stone size, age, serum lymphocyte, platelet counts, and stone density. Of these risk factors, stone size ≥ 7mm (p = 0.012, odds ratio = 5.4) and platelet count ≤ 230K/μL (p = 0.027, odds ratio = 4.9) remained statistically significant on multivariate analysis.Conclusion:Stone size and platelet count were found to be risk factors for surgical intervention in patients with up to 10mm PUS. These findings may assist in identifying patients who are more suitable for conservative approach.     

Pain relief by continuous intraperitoneal nebulization of ropivacaine during gynecologic laparoscopic surgery--a randomized study and review of the literature

STUDY OBJECTIVE: To evaluate the efficacy of intraperitoneal nebulization of ropivacaine on pain relief during and after gynecologic laparoscopic procedures including a review of the literature. DESIGN: Double-blinded, randomized, controlled, clinical trial (Canadian Task Force classification I). SETTING: University hospital ambulatory gynecoendoscopic department. PATIENTS: Forty patients (20 patients in each arm) undergoing elective gynecologic same-day outpatient laparoscopic surgery including unilateral/bilateral salpingo-oophorectomy or unilateral/bilateral ovarian cystectomy. INTERVENTIONS: The study group received 10 mL of 1% ropivacaine and the control group received 10 mL of sterile water by intraperitoneal nebulization. During surgery, vital signs were recorded and summarized. Postoperatively patients were followed up for 24 hours including visual analog scale scores and analgesic use. MEASUREMENTS AND MAIN RESULTS: No significant differences existed between the groups during surgery and at the recovery department in terms of arterial blood pressure (p = .42) or heart rate (p = .60). Regarding postoperative analgesia, no difference existed between the groups in terms of morphine consumption (p = .52) or other analgesics (p = .53). No significant difference existed between the groups in postoperative visual analog scale scores including visceral, abdominal wall, and shoulder pain during rest and during cough at the different time frames (30, 60, and 120 minutes and 6 and 24 hours after surgery). CONCLUSION: Our study is the first to examine the effects of intraperitoneal nebulization of ropivacaine throughout laparoscopic gynecologic procedures on patients undergoing general anesthesia. Nebulization of 100 mg of ropivacaine under our specific regimen of anesthesia does not improve patients' outcome in terms of intraoperative and postoperative pain along with consumption of analgesics. Further research with other regimens is required.     

From pupils to consumers: the transformation of the concept of childhood in Israeli children’s television

This article divides the history of children’s television in Israel in its first decades into three distinct eras: The Single Channel Era (1966–1989), The New Exclusivity Era (1989–2000), and The Age of Multichannel TV (2000–2010). Based on qualitative interviews with 20 central producers, who worked in Israel’s leading channels for children, the article examines the significant changes that occurred in the production field of television for children: from past broadcasts of only public and educational nature in a single Israeli channel, to the current reality of a great number of private channels, some globally owned, broadcasting mainly entertainment. Using Pierre Bourdieu’s cultural theories, this work analyzes the changes that took place in the collective conventions and practices in children’s television in Israel, and in its producers’ concept of childhood: from a national educational service for children, to looking at children as consumers in a media market.     

Internally Displaced “Victims of Armed Conflict” in Colombia: The Trajectory and Trauma Signature of Forced Migration

While conflict-induced forced migration is a global phenomenon, the situation in Colombia, South America, is distinctive. Colombia has ranked either first or second in the number of internally displaced persons for 10 years, a consequence of decades of armed conflict compounded by high prevalence of drug trafficking. The displacement trajectory for displaced persons in Colombia proceeds through a sequence of stages: (1) pre-expulsion threats and vulnerability, (2) expulsion, (3) migration, (4) initial adaptation to relocation, (5) protracted resettlement (the end point for most forced migrants), and, rarely, (6) return to the community of origin. Trauma signature analysis, an evidence-based method that elucidates the physical and psychological consequences associated with exposures to harm and loss during disasters and complex emergencies, was used to identify the psychological risk factors and potentially traumatic events experienced by conflict-displaced persons in Colombia, stratified across the phases of displacement. Trauma and loss are experienced differentially throughout the pathway of displacement.