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Archives of Gynecology and Obstetrics Mar 2024Septate uterus is a congenital malformation associated with adverse reproductive and pregnancy outcomes. It remains controversial whether hysteroscopic septoplasty... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Septate uterus is a congenital malformation associated with adverse reproductive and pregnancy outcomes. It remains controversial whether hysteroscopic septoplasty should be recommended for the treatment of septate uterus, and it is also unclear if different hysteroscopic methods have more favorable outcomes. This study aims to compare the available hysteroscopic techniques of septoplasty for fertility, reproductive, and perioperative outcomes.
METHODS
This systematic review and meta-analysis was conducted following PRISMA guidelines. We searched Medline, Scopus, and Cochrane databases up to April 2023 without language restrictions. Eligible studies had to compare two or more different methods of hysteroscopic septoplasty in women with septate uterus and report on fertility and pregnancy outcomes after a follow-up. Perioperative outcomes were also examined. Data extraction was performed by two independent reviewers using a standardized form. Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Form and Revised Cochrane risk-of-bias tool (RoB 2).
RESULTS
Out of 561 studies identified, 9 were included in the systematic review and meta-analysis. The comparison of different hysteroscopic septoplasty techniques based on the energy used showed higher pregnancy rates after mechanical septoplasty in comparison to electrosurgery, while miscarriage and live birth rates were comparable. Laser vs. electrosurgery and mechanical techniques of septoplasty had comparable pregnancy, miscarriage, and live birth rates. The network meta-analysis after comparing every different method used showed significantly higher clinical pregnancy rate in scissor group in comparison to resectoscope. No significant differences were found among the techniques regarding miscarriage rate and live birth rate.
CONCLUSION
In summary, this systematic review and network meta-analysis suggests that hysteroscopic septoplasty with scissors is associated with higher pregnancy rates compared to resectoscope. However, the limited evidence available and small sample sizes in the included studies indicate that these findings should be interpreted with caution. Further studies are required to determine the effectiveness of various hysteroscopic techniques and guide clinical decision-making in the management of this condition.
Topics: Pregnancy; Female; Humans; Hysteroscopy; Septate Uterus; Abortion, Spontaneous; Network Meta-Analysis; Uterus; Pregnancy Outcome; Fertility; Infertility, Female
PubMed: 37354236
DOI: 10.1007/s00404-023-07109-2 -
Surgical Neurology International 2021Treatment of brain abscess is still a subject of controversy. The main treatment is surgical, although medical therapy alone can be used for selected cases. The...
BACKGROUND
Treatment of brain abscess is still a subject of controversy. The main treatment is surgical, although medical therapy alone can be used for selected cases. The treatment of choice is aspiration, which may be performed with the aid of an endoscope or by freehand technique, with or without stereotactic or intraoperative ultrasound guidance. Excision is valuable in some cases. We are reporting our results of endoscopic approach in 12 patients.
METHODS
This study included 12 patients of brain abscesses treated between January 2015 and January 2018. All the cases except those with small abscesses (<3.0 cm in diameter) were included in the study. Rigid endoscope was used. Follow-up CT scan was done in all cases within 7 and 30 days after surgery. Follow-up periods ranged between 3 and 6 months.
RESULTS
There were 11 patients with a history of chronic otitis media and one patient who suffered from congenital cyanotic heart disease. Glasgow Coma Score (GCS) was 5 in one patient, 13 in two cases, and 14-15 in 9 cases. There were one cerebellar, six temporal, and five frontal abscesses. All the patients recovered completely except one who died (GCS 5). There was no procedure-related complication. Hospital stay ranged from 14 to 45 days with an average of 28 days. The endoscopy aided visualization of multiloculations and septation in eight patients which allowed the opening of the septations and complete evacuation.
CONCLUSION
Endoscopic aspiration is safe, easy, and represents an effective way of treatment of brain abscess through proper visualization. It can be used for ensuring the complete aspiration of contents, control of any bleeding point, and also for multiloculated abscess to identify and open the septations which may not be possible in stereotactic or any other guided aspirations.
PubMed: 33598352
DOI: 10.25259/SNI_800_2020 -
Current Pulmonology Reports 2018We review recent studies of patients with septated malignant pleural effusions, to understand what the clinical implications for patients are and what evidence-based... (Review)
Review
PURPOSE OF REVIEW
We review recent studies of patients with septated malignant pleural effusions, to understand what the clinical implications for patients are and what evidence-based methods should be used to manage these effusions.
RECENT FINDINGS
Fibrinolytics improve effusion size assessed radiologically in patients with a chest drain inserted for septated malignant pleural effusions but this does not translate into an improvement in breathlessness relief or pleurodesis success. Fibrinolytics have also been used in patients with septated effusions associated with indwelling pleural catheters, but dyspnoea relief has not been assessed in this population. Patients with septated effusions or extensive adhesions appear to have a worse prognosis.
SUMMARY
Patients with septated malignant pleural effusions have a poor prognosis and do not gain clinical benefit from fibrinolytics via chest drain. The role of fibrinolytics for septated effusions associated with indwelling pleural catheters requires further study.
PubMed: 29568725
DOI: 10.1007/s13665-018-0194-3 -
Seminars in Thoracic and Cardiovascular... 2024Double inlet left ventricle (DILV) is a form of single ventricle heart disease where both atrioventricular valves enter a single left ventricle. Surgical intervention... (Review)
Review
Double inlet left ventricle (DILV) is a form of single ventricle heart disease where both atrioventricular valves enter a single left ventricle. Surgical intervention may be needed in the neonatal period secondary to systemic outflow tract obstruction or less commonly pulmonary obstruction. Two-dimensional echocardiography can adequately assess newborn anatomy and define the need for surgery. Beyond the newborn period, there is a renewed interest in septation of DILV using intracardiac baffles in a staged approach. Cross sectional imaging can aid in surgical planning. This article will review common anatomic features of DILV and imaging considerations for both single ventricle palliation and DILV septation.
Topics: Infant, Newborn; Humans; Heart Ventricles; Bays; Heart Valves; Echocardiography
PubMed: 38522877
DOI: 10.1053/j.pcsu.2024.01.005 -
Cellular Microbiology Sep 2016Cytokinesis is the final process of the vegetative cycle, which divides a cell into two independent daughter cells once mitosis is completed. In fungi, as in animal... (Review)
Review
Cytokinesis is the final process of the vegetative cycle, which divides a cell into two independent daughter cells once mitosis is completed. In fungi, as in animal cells, cytokinesis requires the formation of a cleavage furrow originated by constriction of an actomyosin ring which is connected to the plasma membrane and causes its invagination. Additionally, because fungal cells have a polysaccharide cell wall outside the plasma membrane, cytokinesis requires the formation of a septum coincident with the membrane ingression. Fission yeast Schizosaccharomyces pombe is a unicellular, rod-shaped fungus that has become a popular model organism for the study of actomyosin ring formation and constriction during cell division. Here we review the current knowledge of the septation and separation processes in this fungus, as well as recent advances in understanding the functional interaction between the transmembrane enzymes that build the septum and the actomyosin ring proteins.
Topics: Actomyosin; Cell Wall; Cytokinesis; Schizosaccharomyces; Schizosaccharomyces pombe Proteins
PubMed: 27155541
DOI: 10.1111/cmi.12611 -
Case Reports in Women's Health Apr 2022
PubMed: 35496576
DOI: 10.1016/j.crwh.2022.e00413 -
Cardiology in the Young Dec 2022
PubMed: 36514994
DOI: 10.1017/S104795112200378X -
Advances in Experimental Medicine and... 2024The formed hearts of vertebrates are widely different in anatomy and performance, yet their embryonic hearts are surprisingly similar. Developmental and molecular... (Review)
Review
The formed hearts of vertebrates are widely different in anatomy and performance, yet their embryonic hearts are surprisingly similar. Developmental and molecular biology are making great advances in reconciling these differences by revealing an evolutionarily conserved building plan to the vertebrate heart. This suggests that perspectives from evolution may improve our understanding of the formation of the human heart. Here, we exemplify this approach by discussing atrial and ventricular septation and the associated processes of remodeling of the atrioventricular junction and formation of the atrioventricular insulating plane.
Topics: Humans; Animals; Biological Evolution; Heart Ventricles; Heart Atria; Heart
PubMed: 38884714
DOI: 10.1007/978-3-031-44087-8_12 -
Journal of Minimally Invasive Gynecology 2014To assess if any difference could be found in uterine vascularization between septate and bicornuate uterus.
STUDY OBJECTIVE
To assess if any difference could be found in uterine vascularization between septate and bicornuate uterus.
DESIGN
Pilot study (Canadian Task Force classification II-2).
SETTING
University hospital infertility clinic.
PATIENTS
One hundred nine women with complete duplication of the uterine cavity. All had already received the final diagnosis of the type of uterine malformation, either septate uterus or bicornuate uterus, via diagnostic hysteroscopy and laparoscopy. Another group of 10 patients with uterine anomalies and affected by ovarian mass were also evaluated via intravenous contrast medium-enhanced ultrasound examination.
INTERVENTIONS
Patients were evaluated using 2-dimensional and 3-dimensional power Doppler imaging of the uterus.
MEASUREMENTS AND MAIN RESULTS
Seventy-three patients with septate uterus, with or without cervical and vaginal duplication, and 36 patients with bicornuate uterus were selected for inclusion in the study. Irregular vascular networks were detected between the 2 hemicavities in the patients with septate uterus. All bicornuate uteri showed a peculiar vascular network between the 2 hemicavities: the main recognizable vessels formed a network depicting the Greek letter γ at the level of the uterine midline. Detection of the γ sign can be used to differentiate septate from bicornuate uterus. This finding was also confirmed in patients who underwent intravenous contrast medium-enhanced ultrasound examination.
CONCLUSIONS
power Doppler provides a new and uninvasive tool for differentiation of septate from bicornuate uterus.
Topics: Adult; Female; Humans; Hysteroscopy; Imaging, Three-Dimensional; Infertility, Female; Laparoscopy; Pilot Projects; Pregnancy; Ultrasonography, Doppler, Color; Urogenital Abnormalities; Uterus
PubMed: 24727032
DOI: 10.1016/j.jmig.2014.03.023