Activiteit

001). We found that the foveal vessel density of the CC was lower in vitelliform stage and significantly increased in vitelliruptive stage (p = 0.031). At EDI-OCT, the SFCT revealed a statistically significant increase in patients compared to controls (p = 0.002) whereas it was similar in the different stages of this dystrophy (p = 0.276). CONCLUSIONS In vitelliform stage of AOFVD, OCTA and EDI-OCT can be useful to avoid mistakes of evaluation, due to the masking effect artifact. OCTA provides us a better understanding of the vascular role in the physiopathology of the macular diseases. V.The incidence of type 2 diabetes mellitus (T2DM) has increased dramatically at an alarming level around the world.T2DM is associated with changeable risk factors in lifestyle as well as genetic and family associated risk factors. find more More importantly, imbalanced or impaired gut microbial distribution (dysbiosis) has been reported as a contributing risk factor in insulin resistance progression in T2DM. Dysbiosis may restructure the metabolic and functional pathways in the intestine which are involved in the development of T2DM. However, several studies have indicated the constructive and helpful effect of prebiotics, probiotics, and fecal microbiota transplantation (FMT) on the improvement of gut microbiota (GM) and accordingly host metabolism. In this review, the association between GM and T2DM have been evaluated and the role of prebiotics, probiotics and FMT, as potential therapeutic approaches have been discussed. Relevant studies were obtained randomly from online databases such as PubMed/Medline and ISI Web of Science. STUDY OBJECTIVE To evaluate the diagnostic accuracy of transvaginal ultrasound in predicting a laparoscopic surgically assigned revised American Society of Reproductive Medicine (ASRM) endometriosis stage. DESIGN Multicenter retrospective diagnostic accuracy study. SETTING Patients attended one of two academic gynecologic ultrasound units and underwent laparoscopy by one of six surgeons in metropolitan Sydney, Australia between 2016 and 2018. PATIENTS Two hundred and four patients with suspected endometriosis. INTERVENTIONS Ultrasound followed by laparoscopy MEASUREMENTS AND MAIN RESULTS Surgical cases were identified. The preoperative ultrasound report and surgical operative notes were each used to retrospectively assign an ASRM score and stage. The breakdown of surgical findings is as follows ASRM 0 (i.e. no endometriosis), 24/204 (11.8%); ASRM 1, 110/204 (53.9%); ASRM 2, 22/204 (10.8%); ASRM 3, 16/204 (7.8%); ASRM 4, 32/204 (15.7%). The overall accuracy of ultrasound to predict the surgical ASRM stage is as follows ASRM 1, 53.4%; ASRM 2, 93.8%; ASRM 3, 89.7%; ASRM 4, 93.1%; grouped ASRM 0/1/2, 94.6%; ASRM 3/4 of 94.6%. Ultrasound has better test performance in higher disease stages. When the ASRM stages are dichotomized, ultrasound has sensitivity and specificity for ASRM 0/1/2 of 94.9% and 93.8% and ASRM 3/4 of 93.8% and 94.9%. CONCLUSION Ultrasound has high accuracy in predicting mild, moderate, and severe ASRM stage of endometriosis and can accurately differentiate between stages when ASRM stages are dichotomized (nil/minimal/mild versus moderate/severe). This can have major positive implications on patient triaging to centers of excellence in minimally-invasive gynecology for advanced-stage endometriosis. STUDY OBJECTIVE To identify patient and hospital characteristics associated with minimally invasive (MIS) hysterectomy. DESIGN Retrospective population-based analysis of administrative data. SETTING Data from the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services Database. PATIENTS Women undergoing hysterectomy for benign gynecologic indications in Illinois, 2016-2018. INTERVENTIONS None MEASUREMENTS AND MAIN RESULTS We determined the significance of the proportion of MIS versus abdominal hysterectomies by patient and hospital characteristics. Multivariable logistic regression was used to determine the association between patient and hospital characteristics and the likelihood of MIS versus abdominal hysterectomy controlling for the simultaneous effects of all patient and hospital characteristics and year of surgery. There were 42,945 hysterectomies for benign indications at 143 non-federal Illinois hospitals from 2016-2018. Over three quarters (32,387, 75.4%) of hysterectomies were MIS. Non-Hispanic Black patients had the lowest percentage of MIS (54.7%) compared to 82.1% among Whites (p 80% MIS, had almost six times the likelihood of MIS (OR=5.89, 95% CI 4.51-7.68). CONCLUSION Black race and a fibroid diagnosis are independently associated with decreased odds of undergoing MIS hysterectomy, while the strongest predictor of undergoing MIS hysterectomy was hospital proportion of minimally invasive procedures. STUDY OBJECTIVE The study objective is to assess the feasibility of LESS for management of non-obstetric, gynecological disease processes in pregnant patients. DESIGN A retrospective case series of 13 pregnant women ages 21 to 42 years old who underwent LESS for various gynecological pathology is presented. If able to be contacted, patients were followed until delivery of the fetus. SETTING Surgeries were performed in a single institution between 2015 and 2019. PATIENTS OR PARTICIPANTS Patients were selected if laparoscopic intervention was indicated. INTERVENTIONS The cases include six ovarian cystectomies and two salpingo-oophorectomies for adnexal masses, one myomectomy for a degenerated fibroid, one salpingectomy for a heterotopic pregnancy, two cerclage placements for recurrent pregnancy loss and cervical insufficiency, and one paratubal cystectomy. Patients underwent LESS through a 2.5 cm umbilical incision. Masses were exteriorized using a laparoscopic specimen retrieval bag, with the exception of two ions or intraoperative complications. Fetal heart rate ranged between 130 and 167 bpm postoperatively. Nine patients who were able to be contacted for follow-up, all had successful deliveries. One patient was healthy at 31+5 weeks without complication at the time of her last follow-up. CONCLUSION LESS may be performed by experienced surgeons on gravid patients in any trimester for adnexal masses, fibroids, heterotopic pregnancy, and cervical incompetence. Future multiple-center studies may provide further evidence that LESS is a feasible and safe option for gynecological surgery during pregnancy.