Hillel Yaffe Medical Center

To investigate the association between an abnormal hysterosalpingogram (HSG) and obstetrical and neonatal outcomes.

A retrospective cohort study comparing outcomes between women with normal versus abnormal tubal patency and uterine cavity on HSG.

Among 2181 women included in the study, 494 (22.6%) had an abnormal HSG. Of these, 207 (42%) presented with uterine abnormalities, 336 (68%) with tubal abnormalities and 49 (10%) with both. The study identified 232 clinical pregnancies in the abnormal HSG group and 814 pregnancies in controls. Women with abnormal HSG showed higher rates of preterm labour (PTL) compared to controls (13.6% vs. 7.7%, p < 0.05, n = 1687). Multivariate analysis revealed that any HSG abnormality was associated with an increased risk of PTL (aOR 2.39, 1.04-5.51). When analysing by type of abnormality, uterine abnormalities increased the risk of preeclampsia (aOR 2.86, 1.06-7.7) and low birthweight (aOR 2.31, 1.0-5.35), while tubal abnormalities were specifically associated with increased risk of PTL (aOR 3.87, 1.63-9.19).

An abnormal HSG study was associated with adverse obstetrical outcomes. Specifically, uterine abnormalities increased the risk of preeclampsia and birthweight below 10th percentile, while tubal abnormalities were associated with a heightened risk of PTL.

Can attenuated total reflection-Fourier transform IR spectroscopy combined with machine learning techniques be used to develop a real-time diagnostic modality for chronic endometritis by analyzing endometrial biopsies obtained during hysteroscopy?Women undergoing hysteroscopy for infertility assessment were enrolled in this prospective study from Jan. 2020 to March 2021.Endometrial biopsies were evaluated using a spectrophotometer, and subsequently via histopathol., including immunohistochem. staining for the multiple myeloma oncogene-1 (MUM-1).Spectroscopy analyses of the pos. and the neg. chronic endometritis groups were compared across various cut-offs of MUM-1 pos. cells per 10 high-power fields (HPF).Machine learning techniques were used to build discrimination models with Matlab and Unscrambler software packages.Fifty-four women were recruited.Four of the 54 measured spectra were discarded due to high measurement noise.Fifty biopsies were finally assessed, and a discriminant model was developed using the Principal Component Anal. and Linear Discriminant Anal. techniques (machine learning).The model was evaluated for accuracy using different MUM-1 cut-offs.Distinct spectral disparities (p < 0.05) were observed between specimens neg. or pos. for chronic endometritis.When employing a cut-off of > 7 MUM-1 cells/10 HPF, the model differentiated pos. and neg. chronic endometritis with 84 % accuracy, 88.8 % sensitivity and 82.9 % specificity.Our findings in this preliminary study support the potential availability of a bedside diagnostic tool based on a model developed using spectroscopy coupled with machine learning.This allowed us to diagnose chronic endometritis in real-time with 84% accuracy, facilitating immediate initiation of appropriate treatment.

The risk of central line-associated bloodstream infection (CLABSI) is associated with central venous catheter (CVC) dwelling time. We implemented a hospital-wide intervention aimed to alert physicians to CVC duration and necessity and to improve the monitoring of CLABSI prevention process measures outside the intensive care unit (ICU).

A retrospective, before-after study that evaluated short-term, nonhemodialysis CVCs in and out of the ICU. The intervention included enhanced bundle-prevention measures monitoring and staff "sensitization" regarding prolonged (> 7 days) CVCs (pCVCs). The ICU intervention also included daily CVC-stewardship visits. We assessed CVC utilizations and CLABSI episodes 20 months before to 19 months after the intervention using Mann-Whitney tests.

Out of the ICU, CVC-utilization ratio (CVC-UR) and pCVC-UR reduced significantly (4.1-2.7/100 hospital days, P = .005; and 28%-21%, P = .02, respectively). Bundle-prevention measures improved, and CLABSI rates reduced postintervention (7.9-3.6/1,000 CVC days, P = .03). In the ICU, pCVC-UR reduced significantly (29%-15%, P < .0001). Baseline ICU-CLABSI rates were low and did not reduce postintervention.

Sensitizing physicians to the existence and duration of CVCs accompanied by improved bundle-prevention measures, resulted in reduction of pCVCs, and outside the ICU, also in reduction of CVC-UR and CLABSI rates.