RESUMEN
BACKGROUND: A septate uterus is a uterine anomaly that may affect reproductive outcome, and is associated with an increased risk for miscarriage, subfertility and preterm birth. Resection of the septum is subject of debate. There is no convincing evidence concerning its effectiveness and safety. This study aims to assess whether hysteroscopic septum resection improves reproductive outcome in women with a septate uterus. METHODS/DESIGN: A multi-centre randomised controlled trial comparing hysteroscopic septum resection and expectant management in women with recurrent miscarriage or subfertility and diagnosed with a septate uterus. The primary outcome is live birth, defined as the birth of a living foetus beyond 24 weeks of gestational age. Secondary outcomes are ongoing pregnancy, clinical pregnancy, miscarriage and complications following hysteroscopic septum resection. The analysis will be performed according to the intention to treat principle. Kaplan-Meier curves will be constructed, estimating the cumulative probability of conception leading to live birth rate over time. Based on retrospective studies, we anticipate an improvement of the live birth rate from 35% without surgery to 70% with surgery. To demonstrate this difference, 68 women need to be randomised. DISCUSSION: Hysteroscopic septum resection is worldwide considered as a standard procedure in women with a septate uterus. Solid evidence for this recommendation is lacking and data from randomised trials is urgently needed. TRIAL REGISTRATION: Dutch trial registry ( NTR1676 , 18th of February 2009).
Asunto(s)
Aborto Habitual/cirugía , Histeroscopía/métodos , Infertilidad/cirugía , Anomalías Urogenitales/cirugía , Útero/anomalías , Aborto Habitual/etiología , Adulto , Tasa de Natalidad , Femenino , Humanos , Infertilidad/congénito , Nacimiento Vivo , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Anomalías Urogenitales/complicaciones , Útero/cirugíaRESUMEN
We have recently identified a soluble plasma form of CD163 sCD163, the macrophage receptor for clearance of haptoglobin-haemoglobin complexes, and we have observed highly elevated levels of sCD163 in subgroups of haematological patients. In the present study, we describe the optimization and characterization of a sandwich ELISA for the determination of the concentration of sCD163 in plasma and serum. The optimal concentrations of antibodies were determined systematically and the assay was calibrated by CD163 purified from human spleen membranes. The minimum detection limit was below 6.25 microg/L. Recovery of CD163 added to plasma samples was 106%. The concentration of sCD163 in paired serum and plasma samples correlated well (r2=0.99); however, serum levels were 1.1 times higher than the plasma levels. The addition of haptoglobin-haemoglobin complexes did not influence the assay. A very high stability of sCD163 was measured in whole blood and in plasma subjected to different temperatures and after repeated freezing and thawing.
Asunto(s)
Antígenos CD , Antígenos de Diferenciación Mielomonocítica/análisis , Antígenos de Diferenciación Mielomonocítica/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Receptores de Superficie Celular/análisis , Receptores de Superficie Celular/sangre , Anticuerpos , Antígenos de Diferenciación Mielomonocítica/inmunología , Calibración , Congelación , Haptoglobinas/análisis , Haptoglobinas/metabolismo , Humanos , Receptores de Superficie Celular/inmunología , Solubilidad , Bazo/químicaRESUMEN
We demonstrate, theoretically and experimentally, that an intense, elliptically polarized, nonresonant laser field can simultaneously force all three axes of a molecule to align along given axes fixed in space, thus inhibiting the free rotation in all three Euler angles. Theoretically, the effect is illustrated through time dependent quantum mechanical calculations. Experimentally, 3, 4-dibromothiophene molecules are aligned with a nanosecond laser pulse. The alignment is probed by 2D ion imaging of the fragments from a 20 fs laser pulse induced Coulomb explosion.
RESUMEN
The aim of this study was to describe the dispatch of emergency ambulance requests in Trondheim and to evaluate the medical justification of such ambulance missions. Data concerning 555 emergency ambulance missions were recorded from March to August 1986. A review of the cases shows that almost 40 per cent were unjustified. However, whether the ambulance missions were justified or not was significantly connected to the age of the patient and with the person requesting the ambulance. Missions requested by health care professionals and missions to elderly patients were the most justified ones. Furthermore, the mission was more justified in the case of internal medical problems than for surgical cases and trauma. We also discuss different ways of improving the use made of emergency medical services outside hospital.