Large deviations for conditionally Gaussian processes: estimates of level crossing probability

The problem of (pathwise) large deviations for conditionally continuous Gaussian processes is investigated. The theory of large deviations for Gaussian processes is extended to the wider class of random processes -- the conditionally Gaussian processes. The estimates of level crossing probability for such processes are given as an application.Comment: Published at https://doi.org/10.15559/18-VMSTA119 in the Modern Stochastics: Theory and Applications (https://vmsta.org/) by VTeX (http://www.vtex.lt/

"EEG abnormalities" may represent a confounding factor in celiac disease. A 4-year follow-up family report

Objective: The occurrence of celiac disease (CD), electroencephalographic (EEG) abnormalities (with "subtle" seizures or even without any clinical seizures), and neurological disorders has been reported since the 1980s, though there has been no definitive consensus about the possible causal relationship. This topic is further complicated by the occurrence in infancy of 'clinical-EEG pictures' called 'benign epilepsy of infancy'. Methods and results: Here, we report a 4-year follow-up on two siblings with newly diagnosed biopsy-proven celiac disease showing EEG abnormalities not responsive to a gluten-free diet. Conclusions: This family report indicates that in patients with neurologically asymptomatic CD and EEG abnormalities, it is advisable to make a differential diagnosis between EEG abnormalities associated with CD and an incidental association with cortical hyperexcitability, with "subtle" seizures or even without any clinical seizures. Practice implications: A long follow-up may sometimes be required, as it was in the family described here, to clarify the etiopathogenetic and therapeutic relationships between clinical and EEG features in CD

The role of tendon and subacromial bursa in rotator cuff tear pain. A clinical and histopathological study

To evaluate a possible association of shoulder pain with the clinical features and the histopathological changes occurring in the ruptured tendon and subacromial bursa of patients with rotator cuff tear

Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) induces anovulation in women of reproductive age, and is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Indeed, PCOS women are characterized by poor quality oocytes. Therefore, a treatment for enhancing oocyte quality becomes crucial for these patients. Myo-Inositol and melatonin proved to be efficient predictors for positive IVF outcomes, correlating with high oocyte quality. We tested the synergistic effect of myo-inositol and melatonin in IVF protocols with PCOS patients in a randomized, controlled, double-blind trial. Five-hundred twenty-six PCOS women were divided into three groups: Controls (only folic acid: 400 mcg), Group A (Inofolic® plus, a daily dose of myo-inositol: 4000 mg, folic acid: 400 mcg, and melatonin: 3 mg), and Group B (Inofolic®, a daily dose of myo-inositol: 4000 mg, and folic acid: 400 mcg). The main outcome measures were oocyte and embryo quality, clinical pregnancy and implantation rates. The treatment lasted from the first day of the cycle until 14 days after embryo transfer. Myo-inositol and melatonin have shown to enhance, synergistically, oocyte and embryo quality. In consideration of the beneficial effect observed in our trial and on the bases of previous studies, we decided to integrate routinely MI and M supplementation in the IVF protocols. The same treatment should be taken carefully in consideration in all procedures of this kin

Urinary hMG (Meropur) versus recombinant FSH plus recombinant LH (Pergoveris) in IVF: A multicenter, prospective, randomized controlled trial

To compare IVF outcome in ovarian stimulation protocols with recombinant FSH plus recombinant LH versus hMG, 122 patients were randomized into two study groups: group A, patients treated with urinary hMG, and group B, patients treated with rFSH plus rLH. The two groups proved to be comparable to the main IVF outcome (pregnancy rate, implantation rate, oocytes, and embryos quality), with an increasing risk of ovarian hyperstimulation in the Pergoveris group. Copyright © 2010 American Society for Reproductive Medicine, Published by Elsevier Inc

First case of transformation for breast fibroadenoma to high-grade malignant cystosarcoma in an in vitro fertilization patient

Objective: To evaluate the possible malignant transformation of fibroadenoma of the breast in patients undergoing an IVF cycle. Design: Case report. Setting: Assisted reproduction center. Patient(s): A 41-year-old female patient undergoing assisted fertilization treatment. Intervention(s): The patient underwent fine needle aspiration biopsy that confirmed fibroadenoma before the IVF attempt. She started a short stimulation protocol with triptorelin and recombinant FSH. After the first unsuccessful IVF attempt, she underwent a second short ovarian stimulation protocol with triptorelin and urinary FSH and she become pregnant. At 17 weeks, due to an increase in volume of the fibroadenoma, an excisional biopsy was performed that showed a malignant phyllode tumor. Then she underwent quadrantectomy. Main Outcome Measure(s): Malignant transformation of breast fibroadenoma. Result(s): Cytologic examination of the first fine needle aspiration biopsy specimen showed a fibroadenoma of the breast; excisional biopsy showed a high-grade malignant cystosarcoma. Conclusion(s): Fibroadenoma was transformed into high-grade malignant cystosarcoma after ovarian stimulation in an IVF patient. (Fertil Steril (R) 2011;96:1126-7. (C) 2011 by American Society for Reproductive Medicine.

Ovarian Stimulation Protocol in IVF: An Up-to-Date Review of the Literature

The Assisted Reproductive Technology (ART) was born in order to help couples with infertility issues in having a baby. The first treatments of IVF used the spontaneous cycle of the women, with the retrieval of only one oocyte. Further studies have shown that it is possible to induce ovulation by administrating gonadotropins during the menstrual cycle, in order to obtain a higher number of oocytes. Many stimulation protocols have been introduced for controlled ovarian hyperstimulation of patients undergoing in vitro fertilization treatment. This review describe the different stimulation protocols using follicle-stimulating hormone (FSH) in combination with Gonadotropin releasing hormone (GnRH) either agonist or antagonist, oral supplementations and ovarian triggering. Using GnRH antagonist protocols have been demonstrated to improve significantly the clinical pregnancy rates for expected poor and high-responders, and in those women at high risk of developing ovarian hyperstimulation syndrome (OHSS). Two meta-analyses showed a better outcome in terms of the live birth rate when highly purified human menopausal gonadotropin (HMG) was used for ovarian stimulation compared with recombinant follicle stimulating hormone (rFSH) in the GnRH agonist long protocol. One of the most efficient stimulation protocol is the use of a combined protocol of human derived urinary FSH (uFSH) and rFSH. Combined protocol has resulted in a significant increase in the proportion of mature metaphase II oocytes and grade 1 embryos when compared to either rFSH or uFSH alone. A significantly higher delivery rate was achieved in rFSH+uFSH compared to the other protocols in poor and normal responders. Studying the combination of melatonin with myo-inositol and folic acid has also showed a higher percentage of mature oocytes in the melatonin group and a higher percentage of G1 embryos as well. However, It remains a crucial step to confirm the efficacy of such protocols for clinical application and it is still needs to comparison studies on larger scale with more focused on the differences in patients' response criteria and additional confounding variables, in order to draw more defined conclusions

Autoimmune response to Chlamydia trachomatis infection and in vitro fertilization outcome

This observational study was conducted in 235 patients undergoing IVF who had a cervical swab positive for Chlamydia trachomatis and who underwent antibiotic treatment until a negative cervical swab before IVF attempt. After oocyte retrieval, follicular fluids of 109 patients out of 228 still showed the presence of IgA antichlamydia antibodies and a significantly lower pregnancy and implantation rate; therefore we conclude that patients should undergo IVF procedure after serum antichlamydia IgA tests negative

Intra- and extraoral implantology and anaplastology: clinical and instrumental evaluation to 7 years

aim. The aim of this work was to evaluate the follow-up of patients treated 7 years after the application of the implant, focusing on the following specific issues: the quality of osseointegration and the presence of adverse reactions, including views from a radiological point of view, the status of the implant and the impact of its success on the quality of life of the patient. Methods. From January 2002 to December 2009, in the Epithesis Center of Sant’Andrea Hospital, 65 surgical patients (31 women and 34 men, mean age 44 years) were treated. This study includes only those with control at 7 years for a total of 12 patients including 7 women and 5 men with a mean age of 43 years. The diagnostic and therapeutic procedures were standard for all patients. Results. With regard to the postoperative clinical control 57 patients had no detectable adverse skin reaction, 3 patients had mild skin redness, inflammatory exudate was present in 1 patient, and inflammation became severe in 1 other patient. Postoperative radiological assessment at 6 months showed no signs of osseointegration in 197 facilities out of 198 (98.9%). Conclusion. Epitheses are an important alternative to conventional reconstructive surgery for patients with craniofacial deficits. Using implant osseointegration could solve the problems caused by using adhesives and the presence of phenomena of irritation to the skin in contact with such substances, greatly improving the quality of life of patients