LIVIVO - Search results -

Search results

Result 1 - 10 of total 143

Search options

Article ; Online: Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic.

Arzilli, G / Forni, S / Righi, L / Barnini, S / Petricci, P / Parisio, E M / Pistello, M / Vivani, P / Gemignani, G / Baggiani, A / Bellandi, T / Privitera, G / Gemmi, F / Tavoschi, L / Porretta, A

The Journal of hospital infection

2023 Volume 137, Page(s) 44–53

Abstract: Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control ... ...

Abstract	Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Methods: Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Results: Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Conclusions: Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.
MeSH term(s)	Humans ; Pandemics ; COVID-19 Testing ; COVID-19/epidemiology ; beta-Lactamases ; Hospitals ; Gammaproteobacteria ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Microbial Sensitivity Tests
Chemical Substances	beta-lactamase NDM-1 (EC 3.5.2.6) ; beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-05-07
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2023.04.016
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 1586: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Details ▾

Article: Digitalizzazione e Virtual Healthcare nell’Azienda Ospedaliero Universitaria Pisana (AOUP) ai tempi dell’emergenza COVID-19.

Milli, C / Molinari, L / Giannetti, I / Frassi, D / Totaro, M / Pagliantini, S / Luchini, G / Briani, S / Baggiani, A

Igiene e sanita pubblica

2021 Volume 77, Issue 3, Page(s) 509–517

Abstract: The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on ... ...

Title translation	Digitization and Virtual Healthcare in a teaching hospital (Pisa, Italy) during COVID-19 emergency.
Abstract	The initial phases of COVID-19 emergency in Italy highlighted the technical delay that the national health system has accumulated in health services digitalization. Italian hospitals rapidly applied a demand systems for virtual health services based on tele-triage, tele-consultation and tele-visits procedures. This led, in the following months, the integration of virtual healthcare services applicable to the Azienda Ospedaliero Universitaria Pisa (AOUP). In particular, BCure system represents an important technological investment for the remote management of care protocols and the analysis of the complete use of health services. This is a unique system for sharing information between specialists, general practitioners and patients.
MeSH term(s)	COVID-19 ; Delivery of Health Care ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Italy ; SARS-CoV-2
Language	Italian
Publishing date	2021-08-03
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3031485-9
ISSN	0019-1639
ISSN	0019-1639
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: First trimester pregnancy outcomes in a large IVF center from the Lombardy County (Italy) during the peak COVID-19 pandemic.

Setti, P E Levi- / Cirillo, F / Immediata, V / Morenghi, E / Canevisio, V / Ronchetti, C / Baggiani, A / Albani, E / Patrizio, P

Scientific reports

2021 Volume 11, Issue 1, Page(s) 16529

Abstract: At the beginning of 2020, the Italian Lombardy region was hit by an "epidemic tsunami" which was, at that point in time, one of the worst pandemics ever. At that moment the effects of SARS-COV 2 were still unknown. To evaluate whether the pandemic has ... ...

Abstract	At the beginning of 2020, the Italian Lombardy region was hit by an "epidemic tsunami" which was, at that point in time, one of the worst pandemics ever. At that moment the effects of SARS-COV 2 were still unknown. To evaluate whether the pandemic has influenced ART (Assisted Reproduction Techniques) outcomes in an asymptomatic infertile population treated at one of the major COVID-19 epicentres during the weeks immediately preceding lockdown. All ART procedures performed during two time periods were compared: November 1st, 2018 to February 28th, 2019 (non-COVID-19 risk) and November 1st, 2019 to February 29th, 2020 (COVID-19 risk). In total 1749 fresh cycles (883 non-COVID-19 risk and 866 COVID-19 risk) and1166 embryos and 63 oocytes warming cycles (538 and 37 during non-COVID and 628 and 26 during COVID-19 risk, respectively) were analysed. Clinical pregnancies per cycle were not different: 370 (25.38%) in non-COVID versus 415 (27.30%) (p = 0.237) during COVID-19 risk. There were no differences in biochemical pregnancy rates 52 (3.57%) versus 38 (2.50%) (p = 0.089) nor in ectopic pregnancies 4 (1.08%) versus 3 (0.72%) (p = 0.594), spontaneous miscarriages 84 (22.70%) versus 103 (24.82%) p = 0.487, nor in intrauterine ongoing pregnancies 282 (76.22%) versus 309 (74.46%) p = 0.569. A multivariate analysis investigating differences in spontaneous miscarriage rate showed no differences between the two timeframes. Our results support no differences in asymptomatic infertile couples' ART outcomes between the pre COVID and COVID-19 periods in one of the earliest and most severe pandemic areas.
MeSH term(s)	Abortion, Spontaneous/epidemiology ; Adult ; Asymptomatic Infections/epidemiology ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19/prevention & control ; Communicable Disease Control/standards ; Female ; Humans ; Infertility/therapy ; Italy/epidemiology ; Male ; Pandemics ; Pregnancy ; Pregnancy Rate ; Pregnancy Trimester, First ; Reproductive Techniques, Assisted/standards ; Reproductive Techniques, Assisted/statistics & numerical data ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-08-16
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-96134-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: One step further: randomised single-centre trial comparing the direct and afterload techniques of embryo transfer.

Levi Setti, P E / Cirillo, F / Morenghi, E / Immediata, V / Caccavari, V / Baggiani, A / Albani, E / Patrizio, P

Human reproduction (Oxford, England)

2021 Volume 36, Issue 9, Page(s) 2484–2492

Abstract: Study question: What are the differences in ease of use between two different embryo transfer (ET) techniques: the preload direct approach and the afterload approach.: Summary answer: The afterload technique seems to reduce the rate of difficult ETs.! ...

Abstract	Study question: What are the differences in ease of use between two different embryo transfer (ET) techniques: the preload direct approach and the afterload approach. Summary answer: The afterload technique seems to reduce the rate of difficult ETs. What is known already: Numerous published trials now document that the ET procedure has an impact on pregnancy and delivery rates after IVF. Difficult transfers should be avoided, as they reduce implantation and pregnancy rates. Preload direct ETs with soft catheters under ultrasound guidance is currently considered the best procedure. However, when using soft catheters, it is not known which technique is preferable or which one should be implemented to reduce the operator factor. Study design, size, duration: This prospective randomised unblinded controlled clinical trial, included 352 ultrasound-guided ETs assigned to either direct ET or afterload ET, between September 2017 and March 2019. The sample size was calculated based on the historical rate of difficult ETs encountered between 2014 and 2015 with a direct ET procedure. Participants/materials, setting, methods: The inclusion criteria were women 18-38 years old, with BMI between 18 and 28, receiving a single-thawed blastocyst transfer. The exclusion criteria were use of testicular sperm and preimplantation genetic testing (PGT) cycles. The primary outcome was the rate of difficult or suboptimal transfers defined as: advancement of the outer sheath (specific for the direct transfer), multiple attempts, use of force, required manipulation, use of a stylet or tenaculum, dilatation, or use of a different catheter. The secondary outcome was clinical pregnancy rate. Main results and the role of chance: A total of 352 frozen ETs were randomised, with 176 patients in each group. The two arms were homogeneous for female and male age, female BMI, duration of infertility, secondary infertility, previous deliveries or miscarriages, myomas, previous surgery to the uterine cavity, cycle day at ovulation trigger, freeze all cycles, first transfers, indication for treatment, endometrial preparation protocol and duration, endometrial thickness, and blastocyst grade at vitrification. Across the entire population, 85 (24.1%) ETs were defined as difficult. The rate of difficult transfers was significantly higher in the direct ET group than in the afterload group: 68 (38.6%) versus 17 (9.7%), respectively (OR 0.17, 95% CI 0.09-0.30, P < 0.001). The mean percentage in the rate of difficult transfers per operator was 22.5% (SD ± 14.5%), of which 36.1% (SD ± 23.4%) were in the direct group compared with 8.6% (± 8.2%) in the afterload group (P < 0.001). The difficult transfer rate among operators varied from 0 to 43.8% (0-77.8% in the direct group and 0 to 25.0% in the afterload group). The clinical pregnancy rates (42.0% vs 48.3%, P = 0.239 in the direct and afterload groups, respectively) were not significantly different between the groups. Limitations, reasons for caution: There were 18 experienced operators who participated in the trial. Conclusions about the pregnancy rate should not be generalised, since the sample analysis was not performed on this outcome and, although clinically relevant, the difference was not significantly different. Wider implications of the findings: The rate of difficult transfers was significantly higher in the direct ET group compared with the afterload ET group, although a wide variation was observed among operators. Further studies regarding the association between transfer technique and ART outcomes are required. Study funding/competing interest(s): No specific funding was sought and there are no competing interests. Trial registration number: NCT03161119. Trial registration date: 5 April 2017. Date of first patient's enrolment: 26 September 2017.
MeSH term(s)	Adolescent ; Adult ; Embryo Implantation ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Male ; Ovulation Induction ; Pregnancy ; Pregnancy Rate ; Prospective Studies ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2021-07-29
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/deab178
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.B 2892: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation.

Graziani, Filippo / Izzetti, Rossana / Lardani, Lisa / Totaro, Michele / Baggiani, Angelo

International journal of environmental research and public health

2021 Volume 18, Issue 7

Abstract: Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt ... ...

Abstract	Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region. A gravimetric impactor was positioned 1 m away and at the same height of the head of the patient. Particles of different sizes (0.3-10 µm) were measured at the beginning of instrumentation, at the end of instrumentation (EI), and then every 15 min up to 105 min. The 0.3-µm particles showed non-significant increases at 15/30 min. The 0.5-1-µm particles increased at EI (
MeSH term(s)	Aerosols/analysis ; Air Pollution, Indoor/analysis ; Environmental Monitoring ; Humans ; Particle Size ; Particulate Matter ; Ultrasonics
Chemical Substances	Aerosols ; Particulate Matter
Language	English
Publishing date	2021-03-24
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18073357
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article: Efficacy of Plant Sterol-Enriched Food for Primary Prevention and Treatment of Hypercholesterolemia: A Systematic Literature Review.

Turini, Elisa / Sarsale, Miriana / Petri, Davide / Totaro, Michele / Lucenteforte, Ersilia / Tavoschi, Lara / Baggiani, Angelo

Foods (Basel, Switzerland)

2022 Volume 11, Issue 6

Abstract: Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and ... ...

Abstract	Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia. Randomized controlled clinical studies reporting the use of PS-enriched foods to reduce LDL-c among adult individuals were retrieved and assessed for risk of bias. Meta-analyses were performed to assess changes in LDL-c by treatment, food matrix, LDL-c range, sterols dosage and risk of bias (RoB). In the 13 studies analyzed, LDL-c in PS-treated participants decreased by an average of 12.14 (8.98; 15.29) mg/dL. PS administration was statistically more effective in patients with LDL-c ≥ 140 mg/dL and for PS dosages > 2 g/day. It can be concluded that PSs can be used as an important primary prevention measure for hypercholesterolemia and as tertiary prevention for cardiovascular events in patients who already have mild to moderate LDL-c. However, in severe hypercholesterolemia and in cases of familial hypercholesterolemia, it is necessary to combine dietary treatment with the use of statins.
Language	English
Publishing date	2022-03-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2704223-6
ISSN	2304-8158
ISSN	2304-8158
DOI	10.3390/foods11060839
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: A Machine Learning Approach Unveils the Relationships between Sickness Behavior and Interoception after Vaccination: Suggestions for Psychometric Indices of Higher Vulnerability.

Alfì, Gaspare / Orrù, Graziella / Menicucci, Danilo / Miccoli, Mario / Casigliani, Virginia / Totaro, Michele / Baggiani, Angelo / Gemignani, Angelo

Healthcare (Basel, Switzerland)

2023 Volume 11, Issue 22

Abstract: Objective: Prior research has suggested a possible connection between vaccination and manifestations of Sickness Behavior; however, a need remains to first delve deeper into this association and second examine how Interoceptive Awareness and emotional ... ...

Abstract	Objective: Prior research has suggested a possible connection between vaccination and manifestations of Sickness Behavior; however, a need remains to first delve deeper into this association and second examine how Interoceptive Awareness and emotional factors may modulate individuals' perceptions of their health status post vaccination. Method: An online retrospective cross-sectional survey of 647 individuals who received a COVID-19 vaccination was conducted. Together with vaccination side effects, socio-demographic characteristics, health status, level of concern about vaccination, and Interoceptive Awareness were collected at the baseline level. Mood, sleep, and Sickness Behavior were assessed at baseline and after vaccination. Data were analyzed using inferential statistics and machine learning techniques. Results: After vaccination, there was a significant increase in Sickness Behavior levels (mean (±SD) SicknessQ T0 = 1.57 (±2.72), mean (±SD) SicknessQ T1 = 5.54 (±5.51); Conclusions: Our results provide new insight into post-immune reactions by highlighting the contribution of Interoceptive Awareness in modulating the severity of Sickness Behavior. This sheds light on the role of awareness of bodily sensations in modulating perceptions of health status, helping to identify the characteristics that make individuals more prone to feeling sick.
Language	English
Publishing date	2023-11-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare11222981
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Implementation of an Environmental Cleaning Protocol in Hospital Critical Areas Using a UV-C Disinfection Robot.

Casini, Beatrice / Tuvo, Benedetta / Scarpaci, Michela / Totaro, Michele / Badalucco, Federica / Briani, Silvia / Luchini, Grazia / Costa, Anna Laura / Baggiani, Angelo

International journal of environmental research and public health

2023 Volume 20, Issue 5

Abstract: Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two ... ...

Abstract	Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two successive patients was evaluated. Twenty high-touch surfaces in different critical areas were sampled according to ISO 14698-1, both immediately pre- and post-cleaning and disinfection standard operating protocol (SOP) and after UV-C disinfection (160 sampling sites in each condition, 480 in total). Dosimeters were applied at the sites to assess the dose emitted. A total of 64.3% (103/160) of the sampling sites tested after SOP were positive, whereas only 17.5% (28/160) were positive after UV-C. According to the national hygienic standards for health-care setting, 9.3% (15/160) resulted in being non-compliant after SOP and only 1.2% (2/160) were non-compliant after UV-C disinfection. Operation theaters was the setting that resulted in being less compliant with the standard limit (≤15 colony-forming unit/24 cm
MeSH term(s)	Humans ; Disinfection/methods ; Robotics ; Xenon ; Hospitals ; Cross Infection ; Ultraviolet Rays
Chemical Substances	Xenon (3H3U766W84)
Language	English
Publishing date	2023-02-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20054284
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Steps forward in embryo transfer technique: a retrospective study comparing direct versus afterload catheters at different time frames.

Cirillo, Federico / Immediata, Valentina / Ronchetti, Camilla / Carletti, Teresa / Morenghi, Emanuela / Albani, Elena / Baggiani, Annamaria / Levi-Setti, Paolo Emanuele

Journal of assisted reproduction and genetics

2023 Volume 40, Issue 12, Page(s) 2895–2902

Abstract: Purpose: To assess whether embryo transfer (ET) technique can influence the clinical pregnancy rate (CPR) and its correlation with the embryo transfer difficulty.: Design: This single center retrospective cohort analysis of fresh and frozen single ... ...

Abstract	Purpose: To assess whether embryo transfer (ET) technique can influence the clinical pregnancy rate (CPR) and its correlation with the embryo transfer difficulty. Design: This single center retrospective cohort analysis of fresh and frozen single blastocyst transfers performed between January 2016 and December 2021 included fresh and frozen single blastocyst transfers performed during the study timeframe. Direct technique was the only one used from January 2016 to September 2017. From September 2017 to March 2019, the choice between the two techniques was given by randomization, due to a clinical trial recruitment. From April 2019, only the afterload technique was used. Preimplantation genetic testing cycles and gamete donation procedures and cycles performed with external gametes or embryos were excluded. CPR was the primary outcome, while difficult transfer rate the secondary one. Univariate and multivariate logistic regressions were performed. Results: During the period, 8,189 transfers were performed. CPR of the afterload group resulted significantly higher compared to the direct group (44.69% versus 41.65%, OR 1.13, 95% CI 1.02-1.25, p = 0.017) and the rate of difficult transfers two-thirds lower (9.06% versus 26.85%, OR 0.27, 95% CI 0.24-0.31, p < 0.001). Conclusion: Our study demonstrated that CPR is significantly affected by the ET technique. In particular, with the afterload protocol, both CPR and easy transfer rates increased. Trial registration: http://clinicaltrials.gov registration number: NCT05364528, retrospectively registered on 3rd of May 2022.
MeSH term(s)	Female ; Humans ; Pregnancy ; Blastocyst ; Cohort Studies ; Cryopreservation ; Embryo Transfer/methods ; Fertilization in Vitro ; Pregnancy Rate ; Retrospective Studies ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-10-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1112577-9
ISSN	1573-7330 ; 1058-0468
ISSN (online)	1573-7330
ISSN	1058-0468
DOI	10.1007/s10815-023-02957-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

Full text online

Accessible to users with ZB MED library card

In stock of ZB MED Cologne/Königswinter

Zs.A 1985: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾

Article ; Online: The human factor: does the operator performing the embryo transfer significantly impact the cycle outcome?

Cirillo, F / Patrizio, P / Baccini, M / Morenghi, E / Ronchetti, C / Cafaro, L / Zannoni, E / Baggiani, A / Levi-Setti, P E

Human reproduction (Oxford, England)

2020 Volume 35, Issue 2, Page(s) 275–282

Abstract: Study question: Is Ongoing Pregnancy Rate (OPR) operator-dependent, and can experience improve embryo transfer efficiency?: Summary answer: OPR is influenced by the operators who perform the embryo transfer (ET), and experience does not assure ... ...

Abstract	Study question: Is Ongoing Pregnancy Rate (OPR) operator-dependent, and can experience improve embryo transfer efficiency? Summary answer: OPR is influenced by the operators who perform the embryo transfer (ET), and experience does not assure proficiency for everyone. What is known already: ET remains the critical step in assisted reproduction. Although many other factors such as embryo quality and uterine receptivity impact embryo implantation, the proper ET technique is clearly an operator-dependent variable and as such it should be objectively standardized. Study design, size, duration: Retrospective comparative analysis including all fresh ETs performed between January 1996 and December 2016 at the Humanitas Fertility Center after IVF-ICSI cycles. Participants/materials, setting, methods: IVF/ICSI fresh ETs performed by 32 operators, 19 824 cycles in all, were analyzed. All transfers consisting of freehand insertion of a preloaded soft catheter into the uterine cavity under transabdominal ultrasound guidance were considered. Two different statistical analyses were performed. First, a logistic regression model with a random intercept for the operator was used to estimate the heterogeneity of the rate of success among operators, accounting for woman age, FSH, number of oocytes retrieved, fertilization rate, year of the procedure, number and stage of transferred embryos and operator's experience. Second, the relationship between experience and pregnancy rate was estimated separately for each operator by logistic regression, and operator-specific results were combined and compared in a random-effects meta-analysis. In both analyses, the operator's experience at time t was measured in terms of number of embryo transfers performed before t. Main results and the role of chance: The heterogeneity among operators was highly significant (P value <0.001) and explained 44.5% of the total variability. The odds ratio of success of the worst operator in respect to the mean was equal to 0.84. For the best operator, the odds ratio of success was equal to 1.13 in respect to the mean. Based on the meta-analysis of the relationship between operator's experience and success rate, it resulted that, on average, the operators' performance did not improve with additional transfers. Limitations, reasons for caution: At our center, operators become independent for ET's after performing between 30 and 50 transfers under supervision. It is also possible that other relevant factors, such as embryologists on duty for the ET, have not been included in the present analysis and this may represent a potential bias. Among these, it should be mentioned that the embryologists on duty for the ET were not taken into consideration. Wider implications of the findings: Continued performance analysis and the use of a digital simulator could help operators to test their expertise over time and either correct poor performance or avoid doing transfers. Study funding/competing interest(s): None. Trial registration number: NCT03561129.
MeSH term(s)	Embryo Implantation ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Pregnancy ; Pregnancy Rate ; Retrospective Studies
Language	English
Publishing date	2020-02-11
Publishing country	England
Document type	Journal Article ; Meta-Analysis
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/dez290
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.B 2892: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

To top

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito