Anatomische Ursachen bei habituellen Aborten: Diagnostik und Therapie

Zusammenfassung: Angeborene Fehlbildungen: Die häufigsten Anomalien des Uterus bei habituellen Aborten sind angeborene Fehlbildungen mit einer Inzidenz von etwa 13 %. Eine frühe, möglichst 3-D-sonographische Diagnostik sollte immer angeboten werden. Der Uterus septus oder subseptus entsteht durch eine fehlende oder mangelnde Resorption des Septums während der Entwicklung. Die Aborte treten meist im späten ersten Trimenon auf. Eine hysteroskopische Septumresektion (Metroplastik) ist angezeigt, da die Geburtenrate auf > 80 % erhöht werden kann. Bei komplizierten Fehlbildungen (Uterus unicornis, bicornis, didelphys) ist eine erweiterte Diagnostik (MRT) sinnvoll, eine operative Korrektur meist aber nicht notwendig, obwohl die Komplikationsrate in der Spätschwangerschaft auf einem hohen Niveau verbleibt. Eine begleitende Nierenfehlbildung sollte stets sonographisch oder MR-diagnostisch ausgeschlossen werden. Erworbene Pathologien: Ob die Diagnose und Behandlung erworbener uteriner Pathologien, z.B. von Myomen, Polypen oder Synechien, das Abortrisiko reduzieren kann, ist noch unklar. Eine operative Behandlung empfiehlt sich dennoch in den meisten Fälle

Surface analysis of Mercury with a mass-spectrometer

Introduction: The European Space Agency BepiColombo mission to Mercury will include a lander, the Mercury Surface Element (MSE). Although the final configuration of instruments is still to be decided, we are developing a mass spectrometer suitable for use on this lander, or in other missions where low mass and low power consumption are a priority. Advantages of a mass-spectrometer over other analytical instruments include sensitivity to almost all elements, high dynamic range, spatially resolved measurements (with an appropriate sampling technique) and the potential to determine isotopic compositions

Clipping polygon faces through a polyhedron of vision

A flight simulator combines flight data and polygon face terrain data to provide a CRT display at each window of the simulated aircraft. The data base specifies the relative position of each vertex of each polygon face therein. Only those terrain faces currently appearing within the pyramid of vision defined by the pilots eye and the edges of the pilots window need be displayed at any given time. As the orientation of the pyramid of vision changes in response to flight data, the displayed faces are correspondingly displaced, eventually moving out of the pyramid of vision. Faces which are currently not visible (outside the pyramid of vision) are clipped from the data flow. In addition, faces which are only partially outside of pyramid of vision are reconstructed to eliminate the outside portion. Window coordinates are generated defining the distance between each vertex and each of the boundary planes forming the pyramid of vision. The sign bit of each window coordinate indicates whether the vertex is on the pyramid of vision side of the associated boundary panel (positive), or on the other side thereof (negative). The set of sign bits accompanying each vertex constitute the outcode of that vertex. The outcodes (O.C.) are systematically processed and examined to determine which faces are completely inside the pyramid of vision (Case A--all signs positive), which faces are completely outside (Case C--All signs negative) and which faces must be reconstructed (Case B--both positive and negative signs)

Threat of taxation, stagnation and social unrest: Evidence from 19th century sicily

Taxation may trigger social unrest, as highlighted by historical examples. At the same time, tax income could boost state capacity which may, in turn, foster political stability. Under-standing the a priori ambiguous taxation-turmoil nexus is particularly relevant for low-income countries today - yet causal evidence on the topic is very scarce. Using a regres-sion discontinuity design, we exploit a unique policy experiment in 19th century Sicily to identify the effect of taxation on social unrest. It turns out that it is mostly the threat of taxation that may distort economic investment and ultimately result in greater political turmoil. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/

Domain and Geometry Agnostic CNNs for Left Atrium Segmentation in 3D Ultrasound

Segmentation of the left atrium and deriving its size can help to predict and detect various cardiovascular conditions. Automation of this process in 3D Ultrasound image data is desirable, since manual delineations are time-consuming, challenging and observer-dependent. Convolutional neural networks have made improvements in computer vision and in medical image analysis. They have successfully been applied to segmentation tasks and were extended to work on volumetric data. In this paper we introduce a combined deep-learning based approach on volumetric segmentation in Ultrasound acquisitions with incorporation of prior knowledge about left atrial shape and imaging device. The results show, that including a shape prior helps the domain adaptation and the accuracy of segmentation is further increased with adversarial learning

Successful Treatment of PulmonaryInvasive Aspergillosis with Voriconazole in Patients who FailedConventional Therapy

Abstract.: Background: The incidence of fungal infections, including those due to Aspergillosis species has continued to increase in recent years. Invasive aspergillosis remains an important cause of morbidity and mortality, despite therapeutics interventions. Patients and Methods: We reported five cases of invasive pulmonary aspergillosis treated with voriconazole failing to respond to conventional treatments. Results: The clinical and radiological resolution of pulmonary aspergillosis reported in these cases following therapy with voriconazole is remarkable, considering the infections had proved refractory to standard antifungal therapies. Long-term therapy (in two cases ≥ 1 year, in one case 6 months) was very well tolerated by patients who were unable to tolerate other antifungal agents. Conclusion: Therapy with voriconazole offers a new therapeutic option for otherwise difficult-to-treat infections and the potential to significantly improve the management of Aspergillosis infection

Travel Rates of Wolves, Canis lupus, in Relation to Ungulate Kill Sites in Westcentral Alberta

Recent advancements in Global Positioning Systems (GPS) radiocollar technology permit analysis of fine-scale animal movements. We used concurrent aerial and GPS monitoring to determine winter travel rates of Wolves (Canis lupus) in relation to ungulate kill sites in managed forest landscapes in westcentral Alberta. Wolves preyed predominately on Moose (Alces alces) and travelled 4.2 times less when near ungulate kill sites than when away from them. As Wolves are thought to be an important factor in Woodland Caribou (Rangifer tarandus caribou) declines, information is needed to assess predation risk to Caribou from Wolves under a variety of landscape conditions. If Wolves have restricted movements near Moose kill sites, this may lead to decreased encounter rates with Caribou in systems where Moose are abundant. Deer (Odocoileus spp.) are probably an important component of this Wolf-prey system but little is currently known about this relationship. Projecting long-term implications of ongoing development activities requires a more detailed understanding of the responses of all species to landscape change

A Systematic Review and Metaanalysis on the Effects of Garlic Preparations on Blood Pressure in Individuals With Hypertension

BACKGROUND Many patients prefer herbal medications to conventional drugs. Limited trial evidence suggests that garlic preparations reduce high blood pressure (BP). METHODS We searched electronic databases through March 2014 to identify all randomized controlled trials that compared a garlic preparation to placebo in hypertensive patients. Trials were required to report BP values at baseline and after a follow-up of at least 4 weeks. RESULTS Nine double-blind trials with 482 individuals fulfilled our inclusion criteria. Included trials were rather small, and the quality of the majority of included trials was moderate. Follow-up ranged from 8 to 26 weeks. All trials reported office BP measurements. Systolic BP and diastolic BP (SBP and DBP) were more effectively reduced in individuals treated with garlic preparations than in individuals treated with placebo. However, heterogeneity was high (weighted mean difference (WMD) for SBP was −9.1mm Hg; 95% confidence interval (CI), −12.7 to −5.4; P for heterogeneity = 0.0006; and I 2 = 71%; WMD for BP was −3.8mm Hg; 95% CI, −6.7 to −1.0; P for heterogeneity = 0.00001; I 2 = 80%). When analyses were restricted to higher-quality trials using intention-to-treat analysis or to trials with concealed treatment allocation and standardized and blinded BP measurement, effect sizes for SBP but not for DBP were lower and heterogeneity disappeared. CONCLUSIONS Although evidence from this review suggests that garlic preparations may lower BP in hypertensive individuals, the evidence is not strong. A well-conducted and powered trial of longer duration is needed to confirm these finding

Comparative efficacies of imipenem, oxacillin and vancomycin for therapy of chronic foreign body infection due to methicillin-susceptible and -resistant Staphylococcus aureus

The efficacies of imipenem when directed against methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains of Staphylococcus aureus were compared with those of oxacillin and vancomycin in a subcutaneous rat model, using chronically infected tissue cages. At three weeks after inoculation, stable chronic infections were established with average bacterial counts exceeding 106cfu/mL tissue cage fluid for both strains. Intraperitoneal administration (twice a day for 7 days) of imipenem (80 mg/kg) or oxacillin (200 mg/kg) produced peak levels of 23 or 45 mg/L and trough levels of < 0⋅1 and 5⋅7 mg/L, respectively. The therapeutic regimens of either imipenem (P < 0⋅001) or oxacillin (P < 0⋅02) administered for 7 days led to significant reductions in bacterial counts in the tissue cage fluids of animals chronically infected with MSSA. In contrast, imipenem was not effective against chronic MRSA tissue cage infections, despite the relatively low MIC of the infecting strain and the use of high dose (120 mg/kg) therapy. In-vitro susceptibility testings of MRSA performed before and after imipenem therapy demonstrated the emergence of a highly resistant subpopulatio

Chronic central neuropeptide Y infusion in normal rats: status of the hypothalamo-pituitary-adrenal axis, and vagal mediation of hyperinsulinaemia

Summary: Neuropeptide Y in the hypothalamus is a potent physiological stimulator of feeding, and may contribute to the characteristic metabolic defects of obesity when hypothalamic levels remain chronically elevated. Since corticosterone and insulin are important regulators of fuel metabolism, the longitudinal effects of chronic (6 days) intracerebroventricular infusion of neuropeptide Y in normal rats on the hypothalamo-pituitary-adrenal axis and on insulin secretion were studied. Neuropeptide Y-infused rats were either allowed to eat ad libitum, or were pair-fed with normophagic control rats. Neuropeptide Y increased the basal plasma concentrations of adrenocorticotropic hormone and corticosterone during the first 2 days of its intracerebroventricular infusion and increased cold stress-induced plasma adrenocorticotropic hormone concentrations. After 4-6 days of central neuropeptide Y infusion, however, basal plasma adrenocorticotropic hormone and corticosterone concentrations were no different from control values (except in ad libitum-fed rats in which corticosteronaemia remained elevated), they were unaffected by the stress of cold exposure, and the hypothalamic content of corticotropin-releasing factor immunoreactivity was significantly decreased. A state of hyperinsulinaemia was present throughout the 6 days of intracerebroventricular neuropeptide Y infusion, being more marked in the ad libitum-fed than in the pair-fed group. The proportions of insulin, proinsulin, and conversion intermediates in plasma and pancreas were unchanged. Hyperinsulinaemia of the pair-fed neuropeptide Y-infused rats was accompanied by muscle insulin resistance and white adipose tissue insulin hyperresponsiveness, as assessed by the in vivo uptake of 2-deoxyglucose. Finally, bilateral subdiaphragmatic vagotomy prevented both the basal and the marked glucose-induced hyperinsulinaemia of animals chronically infused with neuropeptide Y, demonstrating that central neuropeptide Y-induced hyperinsulinaemia is mediated by the parasympathetic nervous syste