Resumption Of Activity Research Articles

Sport and sexual recovery after total hip arthroplasty in young adults: a retrospective cohort study

Abstract Introduction : Total Hip Arthroplasty (THA) is the main treatment for end-stage degenerative hip arthrosis in the elderly, while became increasingly performed as treatment of secondary arthrosis in younger patients, a population at high functional requests in terms of resumption of physical activity and resumption of sexual activity. This study evaluates the physical, sports recovery and the sexual quality of life in young patients undergoing primary THA. Materials and methods Patients undergoing primary THA aged between 18 and 45, operated in a 10 year timeframe, were selected. Demographic, clinical, and radiological data were collected. The Harris Hip Score (HHS) was assessed before and after the surgery. The UCLA Activity Score was collected, sport participation in pre and post-operative period was acquired. The quality of sexual activity (SQoL) before and after surgery was analysed through a qualitative questionnaire. Collected data were also compared on the surgical approach, namely Direct Anterior (DAA), Postero-Lateral (PL) and Direct lateral (DL). Results The population consisted of 242 THA implanted in 232 patients, including 143 males and 89 females, with an average age of 37.4. The mean follow-up period was 51.0 months, with a minimum of 2.9 months and a maximum of 122.6 months. Postoperatively, the average HHS was 90.29 ± 0.9 points, compared to 62.43 ± 1.34 points preoperatively (p < 0.001). The UCLA Activity Score in the postoperative period was 7.17 ± 0.17 matching to intermediate impact sport activity. The 64% of patients reported an improvement in SQoL after-surgery, 73% of which being females that show a significant improvement in SQoL compared to males (p = 0.046). By surgical approach comparison, DAA patients demonstrated better UCLA Activity Score (p = 0.037) and Return to sport (p = 0.027) compared to PL and DL. Conclusion Primary THA surgery in young adults can improve the level of physical activity and promote the involvement of subjects in moderate impact sports. Patients showed a better quality of sexual life compared to the preoperative period, an effect more evident in female patients.

Laparoscopic Appendectomy: A Safe and Feasible Procedure in Emergency Department of a Public Sector Hospital

OBJECTIVES: To evaluate LA (laparoscopic appendectomy) in terms of operative time, post-operative recovery and rate of post-operative complications in Department of Surgery, Benazir Bhutto Hospital, Rawalpindi METHODOLOGY: A prospective Descriptive study. This study was carried out at Benazir Bhutto Hospital, Rawalpindi. The data was collected prospectively for a duration of five years, from March 2019 to March 2024. Data was collected prospectively for patients operated for acute appendicitis by laparoscopic appendectomy with the help of questionnaires. Data of patients undergoing laparoscopic appendectomies over five years was collected by consective non-probabilty sampling technique. RESULTS: 108 patients underwent laparoscopic appendectomy from March 2019 to March 2024 with follow-up of up to 01 month. 50(46.2%) men and 58(53.7%) women were included in the study. The mean age was 28±7.8 years. The mean operative time was 45±24.3 mins. 3.3% of operations required conversion to laparotomy. The mean length of stay was 1.5±3 days. Post-operative pain on the visual analog scale averaged around 6 on day one and reduced thereafter. The mean resumption of physical activity was 6 hrs. post-operatively. There was no death in the 30-day postoperative period. No complication occurred except for port site skin infection in 3 patients, intrabdominal abscess in 1, and fever in 9 patients. CONCLUSION: Our study advocates that laparoscopic appendectomy is a safe minimal invasive procedure with minimal complications.

‛Until you're in the chair and executing your role, you don't know': A qualitative study of the needs and perspectives of people with stroke-related communication disabilities when returning to vocational activity.

People with communication disability after stroke experience low rates of return to vocational roles. Vocational rehabilitation is recommended; however, there are no clear guidelines informing vocational rehabilitation for people with communication disability. Understanding the needs and experiences of this population is critical to improving vocational stroke rehabilitation outcomes. This study aimed to: (1) investigate the experience of vocational rehabilitation for people with communication disability after stroke, (2) identify gaps and, (3) provide preliminary recommendations for tailored service delivery. Seven participants with an identified communication impairment following stroke were recruited from a larger clinical trial of early vocational rehabilitation (20% of total sample, n = 34). To address the study aims, a qualitative design was employed. Semi-structured, in-depth interviews were conducted and analysed using thematic analysis. Data were integrated with demographic and intervention audit data to contextualise participant experiences, identify vocational rehabilitation gaps and inform preliminary recommendations. Participants were five men and two women aged 24-69 years whose communication profiles included difficulties with auditory comprehension and information processing, reading comprehension, thinking, executive function and self-regulation, as well as difficulties with verbal and written expression. Vocational rehabilitation was perceived as beneficial but participants identified gaps including limited access to psychological and peer-based support during early rehabilitation, limitations to accessing specialist vocational rehabilitation programs, barriers to accessing ongoing rehabilitation after resumption of vocational activity, and limited preparedness for the degree of impact that their communication changes had on execution of vocational roles and responsibilities. Vocational environments are communicatively demanding and people living with acquired communication difficulties face a range of vocation-related participation barriers even when communication difficulties are mild. Greater emphasis on evaluating the vocational communication environment and targeted communication training and preparation for colleagues within the workplace is recommended to reduce barriers faced. Interdisciplinary rehabilitation, inclusive of psychological care, may support working-age stroke survivors to recognise and acknowledge changes in their communication function, lead to improved engagement in the rehabilitation process, and ensure early identification of factors likely to influence successful return-to-vocational activity. What is already known on the subject Stroke is common amongst people of working age yet fewer than half of stroke survivors will return to pre-stroke vocational roles. Communication difficulties affect anywhere between 24% and 45% of people after stroke and include changes to language abilities, motor speech, vision, hearing and cognition. This group experiences much lower rates of return to vocational roles when compared to people with stroke who do not have a concomitant communication difficulty. Vocational rehabilitation is recommended. However, currently there is limited evidence to inform vocational rehabilitation guidelines for people with stroke and communication difficulties. Achieving a successful return to vocational activity is associated with improved life satisfaction for people with communication difficulties after stroke and is a key research priority for this population. What this study adds This study investigated the experiences of people with communication difficulty after stroke who reported a goal of returning to pre-stroke vocational activity. Data associated with types of interventions received, the experiences and perceptions of vocational rehabilitation, and experiences of returning to vocational activity were analysed to identify core rehabilitation needs and develop preliminary recommendations to inform future vocational rehabilitation guidelines for this population. What are the clinical implications of this work? The present study provides preliminary evidence that people experiencing communication difficulties after stroke require a more integrated rehabilitation pathway. During early stages of vocational rehabilitation psychological and peer-based support is indicated to support adjustment to changed communication function and to enable productive goal setting and engagement in rehabilitation. Clinicians need to complete a detailed analysis of the vocational communication environment and consider the communication activities involved in the individual's future vocational duties in order to plan meaningful rehabilitation. A multidisciplinary approach is required and additional training for clinicians is indicated to support clinicians to work collaboratively within the vocational setting.

The laser pilonidoplaty

Background: The aim of our study was to evaluate the safety, efficacy and clinical outcome of a laser procedure for the treatment of pilonidal sinus. Objectives were to investigate its effectiveness in terms of operation time, healing time, and the duration of hospitalization, resumption of normal activity, the degree of postoperative complications and rate of recurrence patient satisfaction. Methods: Patients suffering from pilonidal sinus were operated by laser pilonidoplasty at our institute. Laser pilonidoplasty done under spinal anesthesia or local + sedation after a small primary pit excision (0.5-1 cm incision), excision of secondary pits and careful cleaning of the sinus tracts with a curette. After curettage, the laser energy laser set at a wavelength of 1470 nm) was delivered in continuous mode 10 w/sec into the sinus tract f/b saline wash and dressing. Results: Mean duration of procedure was 35.5 min, mean duration of hospital stay was 1.3 days, mean resumption of normal activity within 8.4 days, mean duration for complete wound healing by secondary intention 29.33 days. Among complications, non-healing ulcer reported in 34% and pain noted in 26%. Recurrence rate was 14%. Success rate was 86% and overall patient’s satisfaction was 94%. Conclusions: Laser pilonidopasty proved to be a safe and effective procedure for treating patients suffering from pilonidal sinus with average success rate, less morbidity, fewer complications with better patient satisfaction rate.

Ionospheric Perturbations after Stromboli Volcano Eruptions

Based on data from ground-based vertical sounding of the ionosphere, we analyze disturbances in the region of the maximum of the ionospheric F2-layer during the period of a strong eruption of the Stromboli volcano (Italy) in the form of two explosions in July and August 2019, as well as after the resumption of volcanic activity on October 9, 2022. As characteristics of the ionospheric response to these events, we research variations in the critical frequency of the F2-layer at the Giebilmann, Rome, and San Vito stations located near (no further than 450 km) the volcano. The measurement results indicate the influence on the ionosphere of atmospheric acoustic-gravity waves generated by volcanic activity and causing the appearance of long-lived disturbances in the ionosphere.

Fertility Assessment after Ovarian Transposition in Children and Young Women Treated for a Malignant Tumor.

Ovarian transposition (OT) has been proposed as a protective measure against radiation-induced damage to ovarian function and fertility. Despite its historical use, limited research has focused on evaluating endocrine and exocrine ovarian function after OT performed in adolescents and young adults (AYAs) before or during puberty. The purpose of our study was to investigate the fertility, pubertal development, and ovarian function of women with a previous history of OT during childhood, adolescence or young adulthood. In an observational bicentric retrospective study, we included 32 young female cancer patients who underwent OT before the age of 26 between 1990 and 2015 at Lyon Léon Bérard Cancer Center or Nancy University Hospital. The mean age at the time of OT was 15.6 years with a cancer diagnosis at 15 ± 4.8 years. Among the 10 women attempting pregnancy post-treatment, 60% achieved successful pregnancies. After a mean follow-up of 9.6 ± 7 years, 74% (17 out of 23) of women recovered spontaneous menstrual cycles (seven out of eight evaluable women with OT before or during puberty). Notably, 35% of women who did not attempt pregnancy demonstrated adequate ovarian reserve. Ovarian reserve and function recovery were influenced by the specific chemotherapy received. Importantly, our findings suggest that OT's effectiveness on ovarian activity resumption does not significantly differ when performed before or during puberty compared to pubertal stages. This study contributes valuable insights into the long-term reproductive outcomes of young women undergoing OT, emphasizing its potential efficacy in preserving ovarian function and fertility across different developmental stages.

A comparison of public views about sports concussion recovery with current guidelines: where are the gaps and overlaps?

Background Sports concussion (SC) management guidelines have recently been updated. A key focus is the emphasis on rest (immediately postinjury) followed by gradual resumption of activity (active recovery). This study aimed to explore community views on SC management and compared these with the guidelines. Methods A total of 157 volunteers completed an online SC survey, including listing three pieces of advice for a concussed person immediately postinjury, and after 2weeks (subacute). Quantitative data were statistically compared, and qualitative data underwent content analysis. Results Almost all participants offered different immediate versus subacute advice; however, rest featured highly at both timepoints. Commonly expressed themes, consistent with guidelines were immediate rest; safety and reinjury prevention; and symptom monitoring. Two themes were identified in the community advice with limited emphasis in the guidelines: general health advice and psychological and social support. Expert clinical assessment was not always identified in community advice. Conclusion Community members hold some views that align with expert advice for SC, particularly the importance of immediate postinjury rest. However, there is scope to grow public awareness of some recommended practices, including expert clinical assessment following injury and when to engage in active recovery.

Incidence of reproductive problems following a voluntary waiting period in cows on family type cattle breeding farms in Van province

This study aimed to identify reproductive problems in cows on family type cattle breeding farms in rural areas of Van province using transrectal ultrasonographic examination. The study included 196 cows of various breeds and ages. All cows had calved at least once, completed a voluntary waiting period of at least 50 days postpartum, and were not pregnant at the time of examination. Postpartum days and current body condition scores (BCS) of each cow were recorded. Genital organs of each animal were examined twice using rectal palpation and ultrasonography, at intervals of 7-11 days. Animals with detected corpus luteum in their ovaries were classified as cyclic, while those without were classified as non-cyclic and further categorized according to anestrus types. The average number of days postpartum for cows was determined to be 94.42 days. Based on ovarian examination results, 47.95% (n=94) of the cows were classified as cyclic, while 52.04% (n=102) were classified as non-cyclic. According to anestrus types, 14.71% (n = 15) of the cows were classified as Type I anovulatory anestrus, 25.49% (n = 26) as Type II anovulatory anestrus, 52.94% (n = 54) as Type III anovulatory anestrus, and 4.90% (n = 5) as Type IV anovulatory anestrus. Pyometra was diagnosed in 1.96% (n=2) of the cows. The study concluded that cows on family type cattle breeding farms in rural areas of Van province experienced delayed resumption of postpartum cyclic activity, with high anoestrus rates primarily attributed to nutrition. It was concluded that the widespread use of ultrasonography in family type cattle breeding farms would have significant and positive effects on the reproductive success of cows and sustainable animal breeding.

Retained intracardiac air in cardiovascular surgery: a re-visited problem.

Intracardiac air remains an unsolved problem in the realm of cardiac surgery, leading to embolic events encompassing conduction disturbance, heart failure, and stroke. Transesophageal echocardiography allows the visualization of three distinct types of retained intracardiac air: pooled air, coarse bubbles, and microbubbles. The former two predominantly manifest in the right upper pulmonary vein, left atrium, and left ventricle, exhibiting passive movement along the vessel walls by buoyancy. De-airing, involving "eradication" of air from circulation and "expulsion" of air from the heart into the systemic circulation assumes paramount importance in averting embolic events. Optimal de-airing strategies necessitate the thorough elimination of air during the static phase before the resumption of cardiac activity, achieved through aspiration or guided exit leveraging buoyancy. While the dynamic phase, characterized by active cardiac beating, presents challenges for air eradication, the majority of air expulsion occurs towards the aorta during this period. In this latter phase, collaborative efforts among the surgeon, anesthesiologist, and clinical engineer are pivotal to mitigate the risk of bolus air embolism. The efficacy of carbon dioxide insufflation is limited, as it is rapidly aspirated by wall suction or absorbed into the bloodstream. Consequently, the "air" identified by TEE is acknowledged as conventional air. Understanding the distinctive properties of air as well as timely and judicious collaboration for detection and removal, with the ultimate goal of eradication, emerges as an essential prerequisite for successful de-airing in the evolving era of cardiac surgery.

Early Inflatable penile prosthesis implantation offers superior outcomes compared to delayed insertion following ischemic priapism: a narrative review.

Ischemic priapism is a urological emergency which may lead to irreversible erectile dysfunction. One of the accepted treatments is penile prosthesis implantation. Given the scarcity of studies directly comparing timing of penile prosthesis insertion after ischemic priapism, consensus remains elusive. We aim to compare different studies in the literature concerning advantages and disadvantages of early versus delayed inflatable penile prosthesis following ischemic priapism. We analyzed 8 articles that investigated immediate and delayed inflatable penile prosthesis placement after ischemic priapism. Early inflatable penile prosthesis placement is associated with better outcomes, including pain relief, priapism resolution, penile shortening prevention, and quicker sexual activity resumption. However, it still carries a high risk of complications like edema, infection, and distal perforations. Delayed inflatable penile prosthesis insertion poses surgical challenges due to the potential for extensive corporal fibrosis. Comparative analyses have shown elevated complication rates in patients with ischemic priapism who undergo delayed inflatable penile prosthesis insertion, as opposed to those with early insertion. In studies reporting complications rates, the total complication rate in the early group was 3.37%, significantly lower than the delayed group (37.23%). Most studies support the superiority of early inflatable penile prosthesis placement following ischemic priapism over delayed placement. Further research is, however, needed to establish a global consensus on timing of prosthesis insertion.

Oxytocin, prostaglandin F2α, and scopolamine for uterine involution of dairy cows.

The aim of the study was to compare the effect of three substances with ecbolic activity, Oxytocin, Prostaglandin F2α (PGF2α) and Scopolamine, on the uterine involution process in dairy cows and on the resumption of ovarian activity. Eighty bovine were randomly divided in four groups: GROUP C: 20 cows treated, within 24 h of calving, with 5 mL/head of saline solution; GROUP PG: 20 cows treated, within 24 h of calving, with 150 μg/head of d-cloprostenol; GROUP OX: 20 cows treated, within 24 h of calving, with 50 IU/head of oxytocin acetate; GROUP S: 20 cows treated, within 24 h of calving, with 40 mg/q Scopolamine Butylbromide. Each cow was subjected to blood samples to evaluate the Hydroxyproline (HYP) levels, at T0, within 24 h after calving, and T7, T14, T28, 7, 14, and 28 days after calving, respectively. At T14 and T28, an ultrasound examination was performed to measure the diameter of ex-pregnant horn. In all cows, the reproductive indices (days to first service and number of artificial insemination for conception) were evaluated. In all groups, the HYP concentrations have been rising from T0 to T28, with the maximum levels obtained at T28 in the groups PG and S. As regard the diameter of uterine horn, the comparison among the groups showed significant differences only at T28, with lower values in the group PG and S. In group S and PG, the days to first service were less than other groups. Treatment with Scopolamine and PGF2α resulted in better outcomes, evidenced clinically by more efficient uterine involution and faster ovarian recovery.

Post Partum Resumption of Sexual Activity and Its Determinants in Nursing Mothers: A Port Harcourt Study

Introduction: Influenced by cultural, spiritual and religious beliefs. A lot of couples suspend sexual activities and resume at various different times due to influences by different factors. Materials and Method: This was a descriptive cross-sectional study among 376 postpartum women and nursing mothers visiting the immunization/infant welfare clinic, postnatal and family planning clinic at the University of Port Harcourt Teaching Hospital. Data were obtained using pretested semi-structured interviewer-administered questionnaire, which was designed based on variables from existing literature pretested and revised to ensure the quality of information collected. The data retrieved was analysed and variables presented in tables. Results: Approximately 2/3rd (66.0%) of the women had a tertiary level of education. The result show 200(53.19%) of the women started sexual activity less than 6 weeks after delivery, with about 43.6% of the participants reporting various sexual dysfunctions like loss of desire, dyspareunia, vaginal dryness and others. The majority of the women (89.9%) were knowledgeable about contraception and the majority of those who knew about contraception 222(59%), made use of it. A higher proportion of women who had puerperal complications used contraception. Logistic regression analysis showed that women on contraception were about 12 times more likely to resume sexual activity after 6 weeks. Conclusion: Early resumption of sexual intercourse is common to women irrespective of sociodemographics and obstetric characteristics.

Return to work after out of hospital cardiac arrest, insights from a prospective multicentric French cohort

Rationale: About 60 to 70% of out-of-hospital cardiac arrest (OHCA) survivors who worked before cardiac arrest return to work within one year but the precise conditions for this resumption of professional activity remain little known. The objective of this study was to assess components of return to work among OHCA survivors. Patients and MethodsWe used the French national multicentric cohort AfterRosc to include OHCA survivors admitted between April 1st 2021 and March 31st 2022, discharged alive from the Intensive Care Unit (ICU), and who were less than 65 years old. A phone-call interview was performed one year after OHCA to assess return to work, level of education, former level of occupation as well as neurological recovery. Geographic and socio-economic data from the patient’s residential neighborhoods were also collected. Comparisons were performed between patients who returned to work and those who did not, using non-parametric tests. ResultsOf the 251 patients included in the registry, 86 were alive at ICU discharge and 31 patients that worked prior to the OHCA were included for analysis. Seventeen survivors returned to work after a median delay of 112 days [92–157] Among them, nine (53%) had required initial work adjustments. Overall, only 6 patients (19%) had returned to work ad integrum. Higher educational level, work which required higher competence-level, higher income, living in a better socio-economical neighborhood, as well as better scores on all three standardized MPAI-4 score components (abilities, adjustment and participation) were significantly associated with return to work. Participants that had not returned to work had a significant drop of income (p = 0.0025). ConclusionIn this prospective study regarding French OHCA survivors, return to work is associated with better socio-economical individual and environmental status, as well as better scores on all MPAI-4 components.

Impressive Response to TANDEM Peptide Receptor Radionuclide Therapy with 177Lu/225AcDOTA-LM3 Somatostatin Receptor Antagonist in a Patient with Therapy-Refractory, Rapidly Progressive Neuroendocrine Neoplasm of the Pancreas.

The present report describes the history of a 58-year-old woman with a rapidly progressing neuroendocrine pancreatic tumor (initially G2) presenting with extensive liver, bone, and lymph node metastases. Previous treatments included chemotherapy, hemithyroidectomy for right lobe metastasis, Peptide Receptor Radionuclide Therapy (PRRT) with [177Lu]Lu-DOTATATE, Lanreotide, Everolimus, and liver embolization. Due to severe disease progression, after a liver biopsy revealing tumor grade G3, PRRT with the somatostatin receptor antagonist LM3 was initiated. [68Ga]GaDOTA-LM3 PET/CT showed intense tracer uptake in the liver, pancreatic tumor, lymph nodes, and bone metastases. Three TANDEM-PRRT cycles using [177Lu]LuDOTA-LM3 and [225Ac]AcDOTA-LM3, administered concurrently, resulted in significant improvement, notably in liver metastases, hepatomegaly reduction, the complete regression of bone and lymph node metastases, and primary tumor improvement. Partial remission was confirmed by positron emission tomography/computed tomography, chest-abdomen-pelvis contrast-enhanced computed tomography, and magnetic resonance of the abdomen, with marked clinical improvement in pain, energy levels, and quality of life, enabling full resumption of physical activity.

Changes of the Vagina After Concurrent Radiochemotherapy and Brachytherapy in Cervical Cancer Anatomical and Physiological Changes

The objective of the study: The aim of our study was to highlight the anatomical and physiological changes of the vagina after external radiotherapy and brachytherapy in cervical cancer. Materials and Methods: This was a prospective descriptive study conducted over a period of 6 months, from March to August 2022. A total of 123 women with cervical cancer, treated with concurrent radiochemotherapy and uterovaginal brachytherapy, who reported having had sexual intercourse in the six months prior, were included in the study. Patients were interviewed and examined during post-therapeutic follow-up consultations. Results and Statistical Analysis: The age of the patients (n=123) ranged from 33 to 67 years, with a mean of 49.35 ± 9.84 years. The post-therapeutic follow-up duration ranged from 6 months to 7 years. The most common histological type was squamous cell carcinoma, and the most common FIGO stage was stage II. Treatment consisted of concurrent radiochemotherapy and uterovaginal brachytherapy. Interviews revealed several changes related to the vagina after treatment. More than 65% of patients (n=81) reported the onset or worsening of vaginal dryness, over 50% (n=63) reported the onset or worsening of dyspareunia. Nearly 70% (n=83) reported a decrease in sexual desire frequency or dissatisfaction, and over 60% (n=78) became indifferent to sexual life. Gynecological examination revealed a vaginal length ranging from 2 to 10 cm with a mean of 5.66 ± 2.09 cm, the presence of synechiae and/or stenosis in nearly 43% (n=53), and bleeding in nearly 40% (n=47). In univariate analysis, vaginal dryness and dyspareunia significantly increased with age. Resumption of sexual activity was slower in younger and older women. Among patients followed for two years or less, there was a significant increase in synechiae or stenosis, as well as bleeding. Conversely, the prevalence of vaginal dryness and dyspareunia increased with follow-up duration, especially in those exceeding two years. In groups with vaginal dryness or dyspareunia, a large proportion of patients reported a decrease in sexual desire and indifference to their sexual life. Conclusion: This study revealed that patients with cervical cancer experienced significant anatomical and physiological changes in the vagina after treatment with concurrent radiochemotherapy and uterovaginal brachytherapy, leading to chronic sequelae and sexual disorders. It is therefore essential to implement measures to prevent or limit certain side effects associated with these treatments.

Comparative study of postpartum sexual function: Second-degree tears versus episiotomy outcomes

PurposeThe effects of episiotomy and second-degree tears on postpartum sexual function are key areas of enquiry in women’s health research. Episiotomy and second-degree tears are common procedures and injuries that occur during childbirth. Understanding their impact on post-childbirth sexuality is crucial to women’s overall well-being. This study aimed to examine the relationship between episiotomy, second-degree tears, and post childbirth sexuality.MethodsA cross-sectional design was employed, including 83 women who gave birth to Cáceres in 2017. Participants were evaluated based on sociodemographic and sexual health factors.ResultsNo significant differences were found in dyspareunia or sexual function between women who underwent episiotomies and those with second-degree tears. However, women who underwent episiotomies waited longer before resuming sexual activity after childbirth. Factors such as age, number of previous births, employment status, educational level, and breastfeeding status affected the timing and frequency of postpartum sexual activity.ConclusionDyspareunia negatively affects various aspects of sexual function. When comparing episiotomy and second-degree tears, their impacts on postpartum sexual function were similar. However, episiotomy delays the resumption of sexual activity. Sociodemographic factors significantly influence postpartum sexual health. These findings highlight the importance of individualised interventions and support for new mothers during the postpartum period to address potential sexual health concerns.

Fast and furious: successful survival and resumption of meiosis in immature human oocytes vitrified and warmed using a short protocol

RESEARCH QUESTIONCan immature oocytes vitrified and warmed using a short protocol survive and resume meiosis? DESIGNThis study examined modifications of oocyte vitrification and warming protocols that shorten the time of exposure to vitrification and warming solutions. A total of 561 germinal vesicles (GV), and 218 metaphase I (MI) oocytes that were immature at oocyte retrieval were vitrified at room temperature in 2 minutes. Warming was done at 37°C in 2 minutes. Resumption of meiotic activity was evaluated after 24 and 48 hours of culture. Two different commercially available vitrification and warming kits were used for comparison. RESULTSNinety five percent of GV oocytes survived with no difference observed between kits. The survival of MI oocytes was on average 95.4% and not significantly different between the two kits. Of the 533 GV that survived, 491 converted to MI (92.1%). After culture for 48 hours, 54.4% converted to MII oocytes. In addition, of the 208 MI that survived the warming, 84.1% converted to MII oocytes after culture for 24 hours. CONCLUSIONSVitrification and warming of oocytes at different nuclear maturation stages can be done with a 2-minute exposure time to hypertonic and a 2-minute exposure time to hypotonic solutions. With this approach, the oocytes are less exposed to room temperature during dehydration and rehydration. Warming in 0.5M sucrose helps to maintain and support the potential to resume nuclear meiotic activity of oocytes and conversion from GV to MI and to MII oocytes.

Idiopathic Premature Ventricular Contraction Catheter Ablation, Sedentary Population vs. Athlete's Populations: Outcomes and Resumption of Sports Activity.

There are no investigations about the outcomes of idiopathic PVC catheter ablation (CA) in athletes compared to the sedentary population. We conducted a prospective single-centre observational study. The primary and secondary procedural outcomes were the post-ablation reduction of premature ventricular contractions (PVCs) in an athletes vs. non-athletes group and in agonist vs. leisure-time athletes. The third was the evaluation of the resumption of physical activity and the improvement of symptoms in agonist and leisure-time athletes. From January 2020 to October 2022 we enrolled 79 patients with RVOT/LVOT/fascicular PVC presumed origin. The median percentage of decrease between the pre-procedure and post-procedure Holter monitoring in the non-athletes group was 96 (IQR 68-98) and 98 in the athletes group (IQR 92-99) (p = 0.08). Considering the athletes, the median percentage of decrease in the number of PVCs was 98 (IQR 93-99) and 98 (IQR 87-99), respectively, in leisure-time and agonistic athletes (p = 0.42). Sixteen (70%) leisure time and seventeen (90%) agonist athletes (p = 0.24) have resumed physical activity 3 months after PVC CA; among agonistic athletes, 59% have resumed competitive physical activity. Many leisure-time (88%) and agonist (70%) athletes experienced an improvement in symptoms after ablation. PVC CA was effective and safe in both groups, reducing symptoms and allowing a quick and safe return to sports activities in athletes.

Beyond the Final Heartbeat: Neurological Perspectives on Normothermic Regional Perfusion for Organ Donation after Circulatory Death.

Normothermic regional perfusion (NRP) has recently been used to augment organ donation after circulatory death (DCD) to improve the quantity and quality of transplantable organs. In DCD-NRP, after withdrawal of life-sustaining therapies and cardiopulmonary arrest, patients are cannulated onto extracorporeal membrane oxygenation to reestablish blood flow to targeted organs including the heart. During this process, aortic arch vessels are ligated to restrict cerebral blood flow. We review ethical challenges including whether the brain is sufficiently reperfused through collateral circulation to allow reemergence of consciousness or pain perception, whether resumption of cardiac activity nullifies the patient's prior death determination, and whether specific authorization for DCD-NRP is required. ANN NEUROL 2024;95:1035-1039.

Reinjury Following Return to Play.

Radiologists are frequently called on for guidance regarding return to play (RTP) for athletes and active individuals after sustaining a musculoskeletal injury. Avoidance of reinjury is of particular importance throughout the rehabilitative process and following resumption of competitive activity. Understanding reinjury risk estimation, imaging patterns, and correlation of clinical and surgical findings will help prepare the radiologist to identify reinjuries correctly on diagnostic imaging studies and optimize management for a safe RTP.