Silent onset of postmenopausal endometriosis in a woman with renal failure in hormone replacement therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Postmenopausal endometriosis is a rare form of a common disease, since the absence of estrogenic hormone production should halt disease progression.</p> <p>Case presentation</p> <p>We present the case of a 54-year-old Italian Caucasian woman in surgical menopause with a history of ovarian endometriosis, who underwent voluntary hormone replacement therapy for seven years. She developed postrenal renal failure due to bilateral compression of the pelvic ureteral tract caused by two large, deeply infiltrating endometriotic nodules with no pelvic pain. She underwent operative laparoscopy with adhesiolysis of enteroenteric adhesions and excision of the endometriotic nodules encompassing the juxtavesical tract of the ureters, without obtaining improvement of renal failure.</p> <p>Conclusion</p> <p>Postmenopausal endometriosis can manifest itself in an unpredictable and potentially very serious manner. It is therefore important to carefully evaluate the risks and benefits of administering hormone replacement therapy to patients with previous endometriosis.</p

Developing a New Generation of Integrated Micro-Spec Far Infrared Spectrometers for the EXperiment for Cryogenic Large-Aperture Intensity Mapping (EXCLAIM)

The current state of far-infrared astronomy drives the need to develop compact, sensitive spectrometers for future space and ground-based instruments. Here we present details of the $\rm \mu$-Spec spectrometers currently in development for the far-infrared balloon mission EXCLAIM. The spectrometers are designed to cover the $\rm 555 - 714\ \mu$m range with a resolution of $\rm R\ =\ \lambda / \Delta\lambda\ =\ 512$at the$\rm 638\ \mu$m band center. The spectrometer design incorporates a Rowland grating spectrometer implemented in a parallel plate waveguide on a low-loss single-crystal Si chip, employing Nb microstrip planar transmission lines and thin-film Al kinetic inductance detectors (KIDs). The EXCLAIM$\rm \mu$-Spec design is an advancement upon a successful$\rm R = 64\ \mu$-Spec prototype, and can be considered a sub-mm superconducting photonic integrated circuit (PIC) that combines spectral dispersion and detection. The design operates in a single$M{=}2$grating order, allowing one spectrometer to cover the full EXCLAIM band without requiring a multi-order focal plane. The EXCLAIM instrument will fly six spectrometers, which are fabricated on a single 150 mm diameter Si wafer. Fabrication involves a flip-wafer-bonding process with patterning of the superconducting layers on both sides of the Si dielectric. The spectrometers are designed to operate at 100 mK, and will include 355 Al KID detectors targeting a goal of NEP${\sim}8\times10^{-19}$$\rm W/\sqrt{Hz}$. We summarize the design, fabrication, and ongoing development of these$\rm \mu$-Spec spectrometers for EXCLAIM.Comment: 9 pages, 5 figures, to appear in the Proceedings of the SPIE Astronomical Telescopes + Instrumentation (2022

Systematic review of randomized controlled trials in the treatment of dry eye disease in Sjogren syndrome

Primary Sjögren’s syndrome is an autoimmune disease characterized by dry eye and dry mouth. We systematically reviewed all the randomized controlled clinical trials published in the last 15 years that included ocular outcomes. We found 22 trials involving 9 topical, 10 oral, 2 intravenous and 1 subcutaneous modalities of treatment. Fluoromethalone eye drops over 8 weeks were more effective than topical cyclosporine in the treatment of dry eye symptoms and signs; similarly, indomethacin eye drops over 1 month were more efficacious than diclofenac eye drops. Oral pilocarpine 5 mg twice daily over 3 months was superior to use of lubricants or punctal plugs for treating dry eye, but 5% of participants had gastrointestinal adverse effects from pilocarpine, though none discontinued treatment. In contrast, etanercept, a TNF-alpha blocking antibody, administered as subcutaneous injections twice weekly, did not improve dry eye significantly compared to placebo injections. In conclusion, topical corticosteroids have been shown to be effective in dry eye associated with Sjögren’s syndrome. As some topical non-steroidal anti-inflammatory drugs may be more effective than others, these should be further evaluated. Systemic secretagogues like pilocarpine have a role in Sjögren’s syndrome but the adverse effects may limit their clinical use. It is disappointing that systemic cytokine therapy did not produce encouraging ocular outcomes but participants should have assessment of cytokine levels in such trials, as those with higher baseline cytokine levels may respond better.published_or_final_versio

Experiment for cryogenic large-aperture intensity mapping: instrument design

The experiment for cryogenic large-aperture intensity mapping (EXCLAIM) is a balloon-borne telescope designed to survey star formation in windows from the present to z  =  3.5. During this time, the rate of star formation dropped dramatically, while dark matter continued to cluster. EXCLAIM maps the redshifted emission of singly ionized carbon lines and carbon monoxide using intensity mapping, which permits a blind and complete survey of emitting gas through statistics of cumulative brightness fluctuations. EXCLAIM achieves high sensitivity using a cryogenic telescope coupled to six integrated spectrometers employing kinetic inductance detectors covering 420 to 540 GHz with spectral resolving power R  =  512 and angular resolution ≈4  arc min. The spectral resolving power and cryogenic telescope allow the survey to access dark windows in the spectrum of emission from the upper atmosphere. EXCLAIM will survey 305  deg2 in the Sloan Digital Sky Survey Stripe 82 field from a conventional balloon flight in 2023. EXCLAIM will also map several galactic fields to study carbon monoxide and neutral carbon emission as tracers of molecular gas. We summarize the design phase of the mission