Impact of lifestyle and diet on endometriosis: a fresh look to a busy corner

Endometriosis is a chronic inflammatory disorder with a prevalence of six to ten percent in women of childbearing age. As long as the aetiology of endometriosis is not fully understood and the disease has no definitive treatment, an examination of the environmental factors or interventions that could modify or cure endometriosis would greatly benefit women suffering from this chronic condition. This literature review utilized the electronic databases PubMed, EMBASE, and MEDLINE until February 2021. Studies indicate that fish oil may have a positive effect on reducing endometriosis-related pain due to the effects of pro-inflammatory prostaglandins derived from omega-3 fatty acids. The same effect was seen with the introduction of antioxidant vitamins C, D, and E. There is clinical viability of a low fermentable oligo-, di-, and monosaccharides and polyols diet to successfully reduce the symptoms of patients who suffer from both endometriosis and irritable bowel syndrome. Despite the low level of evidence, there are frequent associations between endometriosis and gastrointestinal conditions in addition to the influence of various nutritional factors on the disease. The management of endometriosis requires a holistic approach focused on reducing overall inflammation, increasing detoxification, and attenuating troublesome symptoms. A dietician may provide great benefit in the management of these patients, especially at younger ages and in early stages. High-level evidence and welldesigned randomized studies are lacking when it comes to studying the effect of lifestyle and dietary intake on endometriosis. Inarguably, further research with a more extensive focus is needed

Application of Deep Learning Model in the Sonographic Diagnosis of Uterine Adenomyosis

Background: This study aims to evaluate the diagnostic performance of Deep Learning (DL) machine for the detection of adenomyosis on uterine ultrasonographic images and compare it to intermediate ultrasound skilled trainees. Methods: Prospective observational study were conducted between 1 and 30 April 2022. Transvaginal ultrasound (TVUS) diagnosis of adenomyosis was investigated by an experienced sonographer on 100 fertile-age patients. Videoclips of the uterine corpus were recorded and sequential ultrasound images were extracted. Intermediate ultrasound-skilled trainees and DL machine were asked to make a diagnosis reviewing uterine images. We evaluated and compared the accuracy, sensitivity, positive predictive value, F1-score, specificity and negative predictive value of the DL model and the trainees for adenomyosis diagnosis. Results: Accuracy of DL and intermediate ultrasound-skilled trainees for the diagnosis of adenomyosis were 0.51 (95% CI, 0.48–0.54) and 0.70 (95% CI, 0.60–0.79), respectively. Sensitivity, specificity and F1-score of DL were 0.43 (95% CI, 0.38–0.48), 0.82 (95% CI, 0.79–0.85) and 0.46 (0.42–0.50), respectively, whereas intermediate ultrasound-skilled trainees had sensitivity of 0.72 (95% CI, 0.52–0.86), specificity of 0.69 (95% CI, 0.58–0.79) and F1-score of 0.55 (95% CI, 0.43–0.66). Conclusions: In this preliminary study DL model showed a lower accuracy but a higher specificity in diagnosing adenomyosis on ultrasonographic images compared to intermediate-skilled trainees

Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer

ULTRAZVUČNI PREGLED PRIMARNOG I SEKUNDARNOG NEPCA

The new 3-4D technologies offer a particular and precise study of some anatomical parts otherwise difficult or impossible to visualize with the traditional 2-D technique. The study of the secondary palate, hard and soft palate of the uvula, in the last two years gained much attention by the researchers because the 3-D ultrasound allows visualizing the secondary palate. Based on the personal experience, the authors illustrate the scan technique of the secondary palate by 3-D ultrasound in sagittal, coronal and axial plane (multiplanar view) with 3D reconstruction, introducing some new possibilities of 3D scan like Tomographic Ultrasound Imaging (TUI) technique. Comparing different technical methods, authors are convinced that most useful is depiction of the palate in the 3-D axial and sagittal plane beginning from the first trimester of pregnancy, but the best results are achieved between the 18 and 25 weeks of gestation. The time needed to render the 3-D image is usually few minutes. The quality of the scan depends, as for the any other 3-D scan, on the fetal position and maternal weight. The association of the facial and palate clefting with chromosomopathies and genetic syndromes which is difficult to depict by 2-D ultrasound, will prompt the investigators to visualize the secondary palate by 3-D scan from the first trimester of pregnancy.Nove ultrazvučne 3-4/D tehnologije nude posebno i precizno izučavanje nekih anatomskih dijelova, koje je inače teško ili nemoguće vidjeti tradicionalnom 2-D tehnikom. Istraživanje sekundarnog nepca, onoga tvrdoga, te ¬mekoga nepca – uvule u posljednje dvije godine je usmjerilo pozornost istraživača, jer 3-D ultrazvuk omogućuje viđenje sekundarnog nepca. Autori na temelju vlastita iskustva prikazuju način snimanja sekundarnog nepca 3-D ultrazvukom, rekonstrukcijom sagitalne, koronarne i aksijalne ravnine, uvodeći nove mogućnosti ultrazvučne tehnike – tomografsko ultrazvučno snimanje (Tomographic Ultrasound Imaging – TUI). Uspoređujući razne metode tehnike autori vjeruju da je najkorisnije otkrivanje nepca u 3-D aksijalnoj i sagitalnoj ravnini, već u prvom tromjesečju, a najbolji je uspjeh otkrivanja s 18–25 tjedana trudnoće. Vrijeme potrebno da se postigne 3-D slika je obično nekoliko minuta. Kvaliteta slike ovisi, kao za bilo koju drugu 3-D sliku, o položaju fetusa i o pretilosti trudnice. Povezanost rascjepa lica i nepca s kromosomopatijama i nasljednim sindromima, koje je teško otkriti 2-D ultrazvukom, omogućuje pretraživaču da pomoću 3-D tehnike vidi sekundarno nepce od prvog tromjesečja trudnoće

Sudden cardiac death during anabolic steroid abuse: Morphologic and toxicologic findings in two fatal cases of bodybuilders

We report two cases of sudden cardiac death (SCD) involving previously healthy bodybuilders who were chronic androgenic-anabolic steroids users. In both instances, autopsies, histology of the organs, and toxicologic screening were performed. Our findings support an emerging consensus that the effects of vigorous weight training, combined with anabolic steroid use and increased androgen sensitivity, may predispose these young men to myocardial injury and even SCD

Breath alcohol analysis: interlaboratory evaluation of silica gel as trapping system.

A polycenric study carried in seven italian forensic laboratories on breath alcohol analysis is repoprted. Breath samples were collected on silica gel crystaland the tubes analyzedby the partecipants using the head space gas-chromatography tecchnique.Results obtained confirmthe relliability of this system. Correlation between blood alcohol concentrations were also made

Combined ultrasound and exome sequencing approach recognizes Opitz G/BBB syndrome in two malformed fetuses

Orofacial clefts are the most common congenital craniofacial anomalies and can occur as an isolated defect or be associated with other anomalies such as posterior fossa anomalies as a part of several genetic syndromes. We report two consecutive voluntary pregnancy interruptions in a nonconsanguineous couple following the fetal ultrasound finding of cleft lip and palate and posterior fossa anomalies confirmed by means of post-termination examination on the second fetus. The quantitative fluorescent PCR, the karyotype, and the comparative genomic hybridization-array analysis after amniocentesis were normal. Exome sequencing on abortive material from both fetuses detected a missense mutation in MID1, resulting in a clinical diagnosis of Opitz G/BBB syndrome. The same mutation was found in the mother and in her brother, who both revealed cerebellar anomalies at an MRI examination. Our study supports the efficacy of exome sequencing in the presence of both a family history suggestive of an inherited disorder and well-documented ultrasound findings. It reveals the importance of a synergistic effort between gynecologists and geneticists aimed at the integration of the most sophisticated ultrasound techniques with the nextgeneration sequencing tools to provide a definite diagnosis essential to orient the final decision and to estimate a proper recurrence risk