Beyond infertility: obstetrical and postpartum complications associated with endometriosis and adenomyosis

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Laparoscopic tubal salvage in an adolescent girl with bilateral isolated tubal torsion

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exploring the relationship between endometriomas and infertility

Several clinical and epidemiological studies demonstrated an association between endometriosis and infertility. A role in the genesis of infertility may be played by endometriomas, which may interfere with ovulation or damage ovarian tissue. Unlike peritoneal implants, the availability of an accurate noninvasive sonographic diagnosis facilitates the investigation of endometrioma associated infertility. The laparoscopic excision of an endometrioma relieves the ovary from the damage caused by the cyst itself, which may be progressive over time, but at the same time is associated with a detrimental effect on ovarian reserve and with high rates of postoperative endometrioma recurrence. Therefore, the management of endometrioma-related infertility should not be based upon surgery alone, but upon a combination of surgery, with a refinement of the operating technique, long-term oral contraceptive, in vitro fertilization and oocyte cryopreservation

Multi-Carrier Code Division Multiplexing of Multi-Layered MPEG4 Video Signals for Real-time Mobile Streaming Applications

In this report, a novel methodology for the efficient multiplexing and transmission of MPEG4- coded video signals over wireless networks will be presented and discussed. The proposed approach relies on the joint exploitation of variable-bit-rate (VBR) multicarrier code-division multiplexing (MC-CDM), together with MPEG4 coding with Fine-Grain-Scalability (FGS) in order to provide unequal error protection to the transmitted video stream.The innovative scheme proposed employs a shared bandwidth partitioned into orthogonal sub-channels in order to multiplex different layers of MPEG-4-coded signals. The highest number of sub-channels (and hence an increased frequency diversity) is assigned to the lowest-bit-rate base layer and the lowest number of sub-channels is assigned to the highest bit-rate enhancement layer. In such a way, base layer information contents are more protected against channel degradations than information contained in FGS enhancement layers, which can only yield a refinement of the quality of the decoded streams. A 2GHz LEO multicast satellite transmission to mobile users has been regarded as the application testbed for the proposed method. Results achieved in terms of PSNR point out that the VBR MC-CDM technique can provide better results than a conventional MPEG-4 single-layer MC-SS transmission.In the framework of a full-digital implementation of reconfigurable multimedia transceivers, the proposed VBR MC-CDM technique may be regarded as an interesting solution for reliable multimedia transmissions in mobile environments

Cross-Layer Adaptation of MPEG4 Video Streaming Over Wireless Networks Using Unequal Error Protection and MC-CDMA

A novel methodology for the efficient multiplexing and streaming of MPEG4 video over wireless networks is presented and discussed. The proposed cross-layer adaptation jointly exploits variable-bitrate (VBR) multi-carrier code-division multiplexing (MC-CDM) and MPEG4 Fine-Grain-Scalability (FGS) in order to provide unequal error protection to the transmitted video stream. A shared bandwidth is partitioned into orthogonal sub-channels in order to multiplex different layers of MPEG4-coded signals. Lower layers are assigned a higher number of sub-channels (and hence an increased frequency diversity) as compared to FGS enhancement layers, in order to provide a differentiated protection against channel degradations. A 2-GHz LEO multicast satellite transmission system has been considered as a application testbed of the proposed methodology. Results achieved in terms of PSNR show that the VBR MC-CDM technique can provide better results than conventional MPEG4 single-layer MC-SS transmission. In the framework of a full-digital implementation of reconfigurable multimedia transceivers, the proposed VBR MC-CDM technique may be regarded as a convenient solution for reliable multimedia transmissions in mobile environments

Medical Management of Endometriosis.

Endometriosis is a chronic medical condition that affects around 6–10 % of reproductive age women. Pelvic pain, dysmenorrhea and infertility are the most common presenting symptoms. The disease is characterized by estrogen dependent growth of the endometrial glands and stroma outside the endometrial cavity. The diagnosis requires a high degree of suspicion and can be only confirmed on histopathology. Treatment includes medical and surgical options. Both hormonal and non-hormonal medical options are available and are tried at first with a goal to control pain and stop the growth of the endometriotic lesions. NSAIDs, oral contraceptive pills, GnRH agonists, aromatase inhibitors are some of the commonly used medications. With more research on the molecular and biochemical aspects of endometriosis, newer targets of therapy are being developed like selective progesterone receptor modulators, anti-angiogenic factors and immunomodulators. In women who do not respond to medical therapy or have severe symptoms, surgical excision of the endometrial lesions and adhesions is often helpful and offers confirmatory diagnosis by histopathology

Is rectovaginal endometriosis a progressive disease ?

progression of the disease and appearance of specific symptoms rarely occurred in patients with asymptomatic rectovaginal endometriosi