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The impact of hydrosalpinx (HSPX) on in-vitro fertilization (IVF) outcome
has recently been the subject of intense debate. Most, but not all, studies
have reported decreased implantation and pregnancy rates and increased
early pregnancy loss in HSPX patients. This has led to prophylactic
salpingectomies prior to IVF in HSPX patients despite the lack of any
prospective studies to suggest that any improvement will occur. Women with
HSPX constitute a heterogeneous population because some conceive easily
with IVF while others do not until after surgical correction. HSPX also
increases in size with ovarian stimulation, and can cause implantation
failure by fluid reflux into the uterine cavity. Careful assessment of the
endometrial lining is mandatory in HSPX to rule out fluid reflux from the
HSPX. We present two case reports of patients whose HSPX enlarged with
ovarian stimulation, causing fluid reflux into the uterine cavity which was
only noted after human chorionic gonadotrophin (HCG) administration.
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A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation 总被引:5,自引:0,他引:5
El Sayed AM Kanafani ZA Mourad FH Soweid AM Barada KA Adorian CS Nasreddine WA Sharara AI 《Gastrointestinal endoscopy》2003,58(1):36-40
BACKGROUND: Colonoscopy preparation regimens are often poorly tolerated because they require use of large-volume bowel preparation solution and diet restrictions for adequate cleansing. This study evaluated the efficacy and tolerability of a split-dose polyethylene glycol-electrolyte solution plus bisacodyl and a regular diet. METHODS: A total of 187 patients (104 men, 83 women; age range 18-91 years) were randomly assigned to receive either 3 L of polyethylene glycol-electrolyte solution (n = 96; Group A) with a liquid diet on the day before colonoscopy, or 2 L of polyethylene glycol-electrolyte solution, one tablet of bisacodyl, and a minimally restricted diet on the day before colonoscopy, and then 1 L of the same solution on the day of colonoscopy (n = 91; Group B). Acceptability, adverse events, and willingness to retake the preparation were assessed by questionnaire. The quality of the preparation was graded by an endoscopist, blinded to the type of preparation, by using a previously described scale (excellent to poor). RESULTS: There were 96 patients in Group A and 91 in Group B. Colon cleansing was significantly better in Group B with regard to the overall quality of the preparation (p lt; 0.05). Compliance was significantly higher in Group B as evidenced by the lower number of patients who discontinued the preparation (4 vs. 15; p = 0.02) because of side effects such as nausea or vomiting. The degree of discomfort, adverse events, and willingness to retake the preparation were not significantly different between the groups. CONCLUSIONS: Colonic preparation with split-dose polyethylene glycol-electrolyte provided better quality colon cleansing and higher compliance, with less dietary restrictions, than preparation with whole-dose polyethylene glycol-electrolyte. 相似文献
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Impact of Calcium and Two Doses of Vitamin D on Bone Metabolism in the Elderly: A Randomized Controlled Trial 下载免费PDF全文
Maya Rahme Sima Lynn Sharara Rafic Baddoura Robert H Habib Georges Halaby Asma Arabi Ravinder J Singh Moustapha Kassem Ziyad Mahfoud Maha Hoteit Rose T Daher Darina Bassil Karim El Ferkh Ghada El‐Hajj Fuleihan 《Journal of bone and mineral research》2017,32(7):1486-1495
The optimal dose of vitamin D to optimize bone metabolism in the elderly is unclear. We tested the hypothesis that vitamin D, at a dose higher than recommended by the Institute of Medicine (IOM), has a beneficial effect on bone remodeling and mass. In this double‐blind trial we randomized 257 overweight elderly subjects to receive 1000 mg of elemental calcium citrate/day, and the daily equivalent of 3750 IU/day or 600 IU/day of vitamin D3 for 1 year. The subjects’ mean age was 71 ± 4 years, body mass index 30 ± 4 kg/m2, 55% were women, and 222 completed the 12‐month follow‐up. Mean serum 25 hydroxyvitamin D (25OHD) was 20 ng/mL, and rose to 26 ng/mL in the low‐dose arm, and 36 ng/mL in the high‐dose arm, at 1 year (p < 0.05). Plasma parathyroid hormone, osteocalcin, and C‐terminal telopeptide (Cross Laps) levels decreased significantly by 20% to 22% in both arms, but there were no differences between the two groups for any variable, at 6 or 12 months, with the exception of serum calcitriol, which was higher in the high‐dose group at 12 months. Bone mineral density (BMD) increased significantly at the total hip and lumbar spine, but not the femoral neck, in both study arms, whereas subtotal body BMD increased in the high‐dose group only, at 1 year. However, there were no significant differences in percent change BMD between the two study arms at any skeletal site. Subjects with serum 25OHD <20 ng/mL and PTH level >76 pg/mL showed a trend for higher BMD increments at all skeletal sites, in the high‐dose group, that reached significance at the hip. Adverse events were comparable in the two study arms. This controlled trial shows little additional benefit in vitamin D supplementation at a dose exceeding the IOM recommendation of 600 IU/day on BMD and bone markers, in overweight elderly individuals. © 2017 American Society for Bone and Mineral Research. 相似文献
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Armstrong A Neithardt AB Alvero R Sharara FI Bush M Segars J 《Fertility and sterility》2004,82(2):495-497
This survey of fellows and reproductive endocrinologists in practice suggests that decreasing numbers of tubal reanastomosis procedures are being performed. This change has occurred both in fellow training and in the clinical practice of reproductive endocrinologists. 相似文献