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Acute Otitis Media and Otitis Media With Effusion in Adults
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
A meta-analysis including 1155 patients concluded that the balloon Eustachian tuboplasty (BET) offers short-term benefit in the majority of cases and medium to longer term benefit in a smaller number of patients. For that reason it has been proposed as a treatment for patients with recurrent OME after grommet insertion. Laser tuboplasty has also been reported.
Gynecologic Microsurgery
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
Several special considerations apply to the use of microsurgery in gynecology. The surgeon must be familiar with the range of infertility disorders and select the proper patient for tubal reconstruction. The operator must be patient and painstaking with a good knowledge of the principles of microsurgical tuboplasty. The first attempt is the one most likely to succeed and it may be the patient’s only chance for pregnancy. Prolonged procedures which last over 4 hr predispose cells and tissues to damage from drying. Traumatic handling of tissues, irrigation with unphysiologic solutions, and prolonged contact with blood predispose the tubes to edema and postoperative adhesions. This operative technique involving the use of optical magnification, miniaturized instruments, and fine sutures requires special skills that can be acquired with patience, practice, perseverance, proper preparation, and sufficient clinical opportunity.
Ethical considerations concerning alternatives to IVF therapies
Published in Elisabeth Hildt, Dietmar Mieth, In Vitro Fertilisation in the 1990s, 2018
Firstly, following the scientific medical point of view, alternatives could avoid creating embryos and thus avoid normative problems – we could improve endoscopic tubal surgery or transcervical balloon tuboplasty, we could experiment with hormonal treatment of insufficient spermatogenesis, we could further evaluate the immunological cause and treatment of male infertility and so on. In this way, we would rely wholly on scientific progress in treating infertility. In this context we should thoroughly consider the underlying concepts of health, treatment and medical care. And we should solve the problems related to the techniques themselves, before they become standard routine (see for example the debate ‘Rewards and Risks in ICSI’ 1995).
Study on diagnosis and management strategies on heterotopic pregnancy: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2023
Yan Zhang, Xiujuan Chen, Yuan Lin, Chengying Lian, Xiumei Xiong
The clinical characteristics of HP are listed in Table 1. The mean age of the 40 patients was 30.4 ± 4.9 (range 21–45) years, the mean body mass index (BMI) was 21.7 ± 2.7 (range 17.3–29.6) kg/m2. Concerning the surgical history, 12 (30.0%) patients underwent uni/bilateral tuboplasty to treat fallopian tube obstruction, and seven (17.5%) patients had bilateral salpingectomy/tubal ligation because of severe hydrosalpinx. Five (12.5%) patients had received unilateral salpingectomy due to tubal EP, and 16 patients had no history of tubal surgery. Fifteen (37.5%) patients had a history of primary infertility, and 25 patients reported a history of pregnancy. All patients had two embryos transferred. Of these women, 15 patients had pregnancies via fresh non-donor embryo transfer cycles, and 25 patients conceived after frozen-thawed embryo transfer.
The effect of low and ultra-low oxygen tensions on mammalian embryo culture and development in experimental and clinical IVF
Published in Systems Biology in Reproductive Medicine, 2020
Manuel Belli, Sevastiani Antonouli, Maria Grazia Palmerini, Serena Bianchi, Sara Bernardi, Mohammad Ali Khalili, Orlando Donfrancesco, Stefania Annarita Nottola, Guido Macchiarelli
Until 1978, women who had no functioning Fallopian tubes were considered sterile. These patients usually underwent reparative surgery or tuboplasty in order to re-establish the normal strait for gametes to transit. Unfortunately, these surgeries often failed (Steptoe and Edwards 1976). In the 1970s, the fertilization of oocytes outside the human body (a process known as in vitro fertilization or IVF) was considered experimental, and when attempted, resulted only in miscarriages or unsuccessful extrauterine pregnancies (Steptoe and Edwards 1976). In 1978, Lesley Brown, the first patient to undergo IVF, underwent a laparoscopic egg retrieval without medications to stimulate her ovaries. The single egg retrieved was fertilized in the laboratory, and then transferred into her uterus. Steptoe and Edwards (1978) successfully obtained the first live birth from IVF.