The uterine junctional zone: A 3-dimensional ultrasound study of patients with endometriosis

The uterine junctional zone (JZ) alterations are correlated with adenomyosis. An accurate evaluation of the JZ may be obtained by 3-dimensional transvaginal sonography (TVS). The aim of the present prospective study was to assess the value of detectable alterations by 3-dimensional TVS of the JZ in patients with pelvic endometriosis (diagnosed by laparoscopy and histologic condition) and to compare these findings with those of women without pelvic endometriosis

Temporary techno-social gatherings? A (hacked) discussion about open practices

This paper is rooted in an experimental inquiry of issue-oriented temporary techno-social gatherings or TTGs, which are typically referred to as hackathons, workshops or pop-ups and employ rapid design and development practices to tackle technical challenges while engaging with social issues. Based on a collaboration between three digital practitioners (a producer, a researcher and a designer), qualitative and creative data was gathered across five different kinds of TTG events in London and in Tartu which were held in partnership with large institutions, including Art:Work at Tate Exchange within Tate Modern, the Mozilla Festival at Ravensbourne College and the 2017 Association of Internet Researchers conference hosted in Tartu. By analysing data using an open and discursive approach manifested in both text and visual formats, we reflect on the dynamic and generative characteristics of TTG gatherings while also arriving at our own conclusions as situated researchers and practitioners who are ourselves engaged in increasingly messy webs where new worlds of theory and practice are built

The politics of age and generation at the GAZE International LGBT Film Festival in Dublin

Despite their global proliferation, queer film festivals, like film festivals more broadly, are somewhat understudied within the social sciences. This is despite scholarship within film studies that argues that they are significant sites of queer collectivity and sociality. This article examines queer film festivals as sites for the production of community and queer bonds. The authors argue that questions of age, temporality and intergenerationality are central to discourses of community mobilized by festival organizers. The article draws on empirical material from a qualitative study of the GAZE International LGBT Festival in Dublin – which formed part of a larger comparative study of the cultural activist politics of queer film festivals in Europe. Ken Plummer has argued for a greater appreciation of the role of time and generation within sexuality studies. Age, temporality and intergenerationality emerged as important issues within interviews conducted with organizers and volunteers at the festival. The analysis of these issues focuses on three key themes: (1) GAZE as a site of intergenerational community; (2) GAZE as a site of remembrance; and (3) demography and the sustainability of the festival. The article argues that the festival provides a distinctive site of intergenerational queer bonds; and that despite the creation of transnational spaces and discourses, references to the nation and national identity remain central to bonding experiences at the festival

Echocardiographic measurements and cardiac anatomy in healthy Western hognose snakes (Heterodon nasicus)

This study aims to describe the most important cardiac structures in the Heterodon nasicus through echocardiography and anatomical dissection. Echocardiographic and echo-Doppler measurements were performed on twenty healthy adult Heterodon nasicus (10.10). The values of the ventricular length, aortic diameter, pulmonary trunk diameter, the mean thickness of the interventricular septum, and thicknesses of the wall of the cavum pulmonale (Cav. P) and cavum arteriosum (Cav. A), were measured. The aortic flow and pulmonary trunk flow were recorded. Two dead specimens (1.1) were dissected. The male's pulmonary trunk diameter was bigger compared to the female's in both the long and short axis. The reproductive ecology of Heterodon nasicus has yet to be fully elucidated upon, however, male territorialism and dispersal from the hibernacula, and multiple male courtships toward a single female were described, hence, the more active reproductive activity of the male and the consequent sexual selection toward a higher aerobic performance can be hypothesised. A moderate interventricular right to left shunt was noticed in the Cav. V of all the specimens, which is considered normal and should not confuse the clinician. Congenital defects, cardiomyopathies, valvulopathies, and pericardial diseases are known to occur in ophidians and other reptiles. Reliable data and profound knowledge of the anatomy and physiology of the ophidian heart are fundamental for the in vivo diagnosis of cardiac diseases in snakes

Echocardiographic measurements and cardiac anatomy in healthy Western hognose snakes (Heterodon nasicus)

This study aims to describe the most important cardiac structures in the Heterodon nasicus through echocardiography and anatomical dissection. Echocardiographic and echo-Doppler measurements were performed on twenty healthy adult Heterodon nasicus (10.10). The values of the ventricular length, aortic diameter, pulmonary trunk diameter, the mean thickness of the interventricular septum, and thicknesses of the wall of the cavum pul-monale (Cav. P) and cavum arteriosum (Cav. A), were measured. The aortic flow and pulmonary trunk flow were recorded. Two dead specimens (1.1) were dissected. The male's pulmonary trunk diameter was bigger compared to the female's in both the long and short axis. The reproductive ecology of Heterodon nasicus has yet to be fully elucidated upon, however, male territorialism and dispersal from the hibernacula, and multiple male courtships toward a single female were described, hence, the more active reproductive activity of the male and the conse-quent sexual selection toward a higher aerobic performance can be hypothesised. A moderate interventricular right to left shunt was noticed in the Cav. V of all the specimens, which is considered normal and should not confuse the clinician. Congenital defects, cardiomyopathies, valvulopathies, and pericardial diseases are known to occur in ophidians and other reptiles. Reliable data and profound knowledge of the anatomy and physiology of the ophidian heart are fundamental for the in vivo diagnosis of cardiac diseases in snakes

Medical treatment of ovarian endometriomas: a prospective evaluation of the effect of dienogest on ovarian reserve, cyst diameter, and associated pain

The aim of the present study was to evaluate the effect of medical treatment of ovarian endometriomas on cyst diameter, associated pain, and ovarian reserve as measured with antral follicle count (AFC) and anti-Mullerian hormone (AMH). In this prospective study, 32 patients with unilateral endometrioma associated with pelvic pain, underwent 6-month medical treatment with dienogest. Before treatment, and at the end of 6\u2009months of treatment, patients underwent evaluation of endometrioma diameter and AFC at transvaginal ultrasonography, measurement of AMH, and evaluation of associated pain. Mean cyst diameter was 4.0\u2009\ub1\u20091.3\u2009cm at baseline, and 2.4\u2009\ub1\u20091.2\u2009cm after 6\u2009months of treatment (p\u2009<\u2009.0001), for a reduction in diameter of 40% and a reduction in volume of 79%. Mean visual analog scale score at enrollment was 6.3\u2009\ub1\u20092.0, with a significant improvement at 6\u2009months (0.9\u2009\ub1\u20091.0, p\u2009<\u2009.0001). AFC for the affected ovary improved from 4.2\u2009\ub1\u20092.8 at baseline, to 8.6\u2009\ub1\u20094.2\u2009cm after 6\u2009months (+105%; p\u2009<\u2009.0001). AMH did not change significantly from baseline (3.40\u2009\ub1\u20092.32\u2009ng/mL) to end of treatment (2.80\u2009\ub1\u20091.90\u2009ng/mL, -18%, p\u2009=\u2009.27). Medical treatment with dienogest significantly reduces endometrioma diameter and associated pain, whereas the ovarian reserve appears to be preserved, with a significant improvement of AFC and no significant change in AMH

Antimüllerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis

Objective: To evaluate if the presence of endometriomas impacts on the ovarian reserve as evaluated with antimüllerian hormone (AMH). Design: Systematic review and meta-analysis. Setting: Not applicable. Patient(s): Patients with unoperated endometriomas versus controls without endometriomas. Intervention(s): Electronic databases searched up to June 2017 to identify articles evaluating AMH levels in patients with unoperated endometriomas versus controls without endometriomas. Main Outcome Measure(s): The primary analysis was aimed at evaluation of AMH levels (mean and SD) in patients with and without endometriomas. Secondary analyses were aimed at evaluating AMH levels in patients with ovarian endometriomas compared to patients with either non-endometriosis benign ovarian cysts or healthy ovaries. Result(s): Of the 39 studies evaluated in detail, 17 were included, for a total of 968 patients with endometriomas and 1874 without endometriomas. AMH was significantly lower in patients with unoperated endometriomas compared to patients with no endometriomas (mean difference −0.84, with 95% confidence interval [CI] −1.16 to −0.52). At secondary analyses, AMH in patients with endometriomas was significantly lower both versus non-endometriosis benign ovarian cysts (mean difference −0.85, 95% CI −1.37 to −0.32, and versus women with healthy ovaries (mean difference −0.61, 95% CI −0.99 to −0.24). Conclusion(s): Ovarian reserve evaluated with AMH is reduced in patients with ovarian endometriomas compared both to patients with other benign ovarian cysts, and to patients with healthy ovaries

The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: A systematic review and meta-analysis

STUDY QUESTION: Does surgical treatment of endometriomas impact on the ovarian reserve as evaluated with antral follicle count (AFC)? SUMMARYANSWER: This meta-analysis of published data shows that surgery for endometrioma does not significantly affect ovarian reserve as evaluated by AFC. WHAT IS KNOWN ALREADY: Surgical excision of an ovarian endometrioma significantly affects ovarian reserve evaluated with anti-Mullerian hormone (AMH) levels. Data for other reliable markers of ovarian reserve, such as AFC, have not been pooled in meta-analyses. STUDY DESIGN, SIZE, DURATION: A systematic review with electronic searches of PubMed, MEDLINE and Embase up to April 2014 was conducted to identify articles evaluating AFC before and after surgery for ovarian endometriomas, or before or after surgery forthe affected versus the contralateral ovary. PARTICIPANTS/MATERIALS, SETTING, METHODS: Ofthe 24 studies evaluated in detail, 13 were included for data extraction and meta-analysis, including a total of 597 patients. The primary outcome at pooled analysis was AFC (mean and SD) for affected ovaries before and after surgery. Secondary outcomes were AFC for the affected ovary versus the contralateral ovary before surgery, and AFC for the operated versus the contralateral ovary after surgery. The data were pooled using the RevMan software by the Cochrane Collaboration. Heterogeneity between studies was based on the results ofthe φ2 and I2 statistics. A random-effect model was used forthe meta-analysis because of high heterogeneity between studies. MAIN RESULTS AND THE ROLE OF CHANCE: AFC for the operated ovary did not change significantly after surgery (mean difference 0.10, 95% CI 2 1.45 to 1.65; P = 0.90). Lower AFC for the diseased ovary compared with the contralateral one was present before surgery, although the difference was not significant (mean difference 22.79, 95% CI 27.10 to 1.51; P = 0.20). After surgery, the operated ovary showed a significantly lower AFC compared with the contralateral ovary (mean difference 2 1.40, 95% CI 22.27 to 20.52; P = 0.002). LIMITATIONS, REASONS FOR CAUTION: Heterogeneity among the selected studies was high; therefore, limiting the conclusions of the present systematic review. WIDER IMPLICATIONS OF THE FINDINGS: Ovarian reserve evaluated with AFC is not reduced after surgical treatment of an endometrioma. A lower AFC is present for the affected ovary both before and after surgery. Recently, concerns have been raised as to the reliability of AMH as a marker of ovarian reserve. Based on the present findings, surgical treatment of an endometrioma may be considered safer for the ovarian reserve than previously thought. study funding/competing interests: No external funding was sought or obtained for this study. No conflicts of interest are declared

Clinical outcomes after resectoscopic treatment of cesarean-induced isthmocele: a prospective case-control study

OBJECTIVE: Isthmocele represents a reservoir on the anterior wall of the uterine isthmus or of the cervical canal at the site of a previous cesarean delivery scar. Recently, it has been clarified that it might be the cause of several gynecologic symptoms, as most common abnormal uterine bleeding. Hysteroscopy and trans-vaginal ultrasound are considered the gold standard for the diagnosis of this defect. Resectoscopic treatment can be considered effective in small size defects, but no randomized clinical trials are available. This is a prospective controlled study to assess feasibility and efficacy of surgical hysteroscopic treatment of cesarean-induced isthmocele on symptom relief. PATIENTS AND METHODS: Diagnostic hysteroscopy was performed as an office procedure in all 47 patients included in the study to confirm and identify the size of the defect. Surgical hysteroscopic treatment was performed in a selected group of patients (n = 23) having no more desire to conceive. Outcomes were measured three months later and compared in the operative hysteroscopy versus diagnostic hysteroscopy group. RESULTS: The duration of periods shortened significantly (p = 0.0003) compared with the duration of menses before operative hysteroscopy in the treated group. Moreover, symptom relief was significantly better in treated patients compared with controls (p < 0.0001). CONCLUSIONS: Resectoscopic treatment of isthmocele offers the possibility of an effective, safe and well-tolerated resolution of associated bleeding symptoms, having an excellent impact on the length of menses. To our knowledge, this is the first prospective controlled trial demonstrating better outcomes of resectoscopic treatment of isthmocele in solving symptoms compared with expectant management

Ovarian reserve reduction with surgery is not correlated with the amount of ovarian tissue inadvertently excised at laparoscopic surgery for endometriomas

The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Müllerian hormone (AMH) serial measurements and to compare AMH values with the number of inadvertently removed follicles in histological specimens. Fifty-two women were enrolled: 34 patients with endometriomas (group 1) and 18 patients with other benign ovarian cysts (group 2). All patients underwent laparoscopic cystectomy performed by a single experienced surgeon. The AMH was measured before, and 1, 3, and 6 months after cystectomy in group 1, and before and 6 months after surgery in group 2. Preoperative AMH levels (mean [standard deviation, SD]) in group 1 (3.39 [2.43] ng/mL) were not significantly different from group 2 (3.74 [2.57] ng/mL; P =.68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P =.003), and of 63.1% at 3 months (1.25 [1.00]; P =.007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (+9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 (P =.012), and by 29.5% in group 2 (P =.200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas (P =.006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas (P =.669). In conclusion, AMH decreases significantly after surgical excision of ovarian endometriomas. The postoperative decrease does not appear to correlate with the amount of ovarian tissue inadvertently excised with the endometrioma wall