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Objective This study sought to examine whether hysterosalpingosonography (sono-HSG) is as effective as hysterosalpingography (HSG) in facilitating conception by comparing pregnancy rates in the 6 months following the procedures. Methods This retrospective noninferiority study (Canadian Task Force classification II-2) was conducted at a tertiary university centre. The investigators studied 440 consecutive eligible infertile women. Bilateral tubal occlusion, severe male infertility, and having undergone both procedures were exclusion criteria. Tubal testing, as part of the infertility workup, was performed by either sono-HSG or HSG. The primary outcome was pregnancy, defined as a positive fetal heartbeat on ultrasonographic examination, in the 6 months following the procedure. Results A total of 57 pregnancies (26%) were observed in the HSG group and 33 (15%) in the sono-HSG group. Adjusted and non-adjusted relative risks of pregnancy in the 6 months following sono-HSG compared with HSG were 0.61 (95% CI 0.42–0.89) and 0.58 (95% CI 0.39–0.85). Adverse events were infrequent with both procedures (sono-HSG, 1%; HSG, 4%; P = 0.16). Conclusion This study suggests that uterine flushing as performed during sono-HSG is not as effective as when performed during HSG to increase the chances of pregnancy, but further studies will be required because of bias related to the retrospective study design.

Objective: The objective of this study was to establish the frequency of anxiety and depressive symptoms among women diagnosed with unexplained infertility and to identify risk factors. Methods: We conducted a descriptive cross-sectional study. Forty-two women from the CHU de Quebec fertility clinic were recruited. Women completed the ‘Hospital Anxiety and Depression Scale’ (HADS) self-administered questionnaire, used to estimate prevalence of anxiety and depressive symptoms (score ≥ 8). Results: Overall, 55% ( n = 23) of participants were identified with anxiety or depressive symptoms according to the HADS questionnaire. Anxiety symptoms were more frequent (55%) compared with depressive symptoms (10%). According to a logistic regression model, being under 35 years old [odds ratio (OR) = 16.6, confidence interval (CI): 1.9–25.0], never had a previous spontaneous abortion (OR = 5.6, CI: 1.1–43.5) and never sought fertility treatment (OR = 5.5, CI: 1.1–45.4) were associated with a higher risk of anxiety and depressive symptoms. Conclusion: Anxiety and depressive symptoms are common among women with unexplained infertility, and strategies should be developed to better support and treat this high-risk population.

This study aimed to compare heterosexual mixed-weight (one overweight and one healthy weight partner) and matched-weight couples on their relationship functioning and eating behaviors. One hundred seventy- four adult couples were recruited and grouped based on their body mass index. They completed a survey online. It was expected that mixed-weight couples would report poorer marital satisfaction and more eating related problems than matched-weight couples, especially among couples with overweight women and healthy weight men. Results showed that men from mixed-weight couples were less satisfied of their relationship and their sexuality compared to men from matched-weight couples. Thus, a gap between partners’ weight seems to be associated with men’s dissatisfaction, no matter which partner is overweight. However, this weight asymmetry has no impact on women’s satisfaction. These findings provide an informative contribution to scientific literature on the impact of weight asymmetry on couple relationship.

This systematic literature review addressed the efficacy of 15 cognitive intervention programs that have been tested in individuals presenting with mild cognitive impairment of the amnestic type (MCI-A) possibly at risk to progress toward dementia. MEDLINE, PsycINFO, and Current Content databases were searched using the following key terms: cognitive training, cognitive stimulation, cognitive rehabilitation, neuropsychological intervention, memory training, memory stimulation, and Mild Cognitive Impairment. The data showed statistically significant improvements at the end of training on 44% of objective measures of memory, when compared with 12% of objective measures of cognition other than memory. Statistically significant improvements after treatment were obtained on 49% of subjective measures of memory, quality of life, or mood. Samples sizes ranged from 1 to 193 patients with MCI-A but were usually < or =30. Five studies were randomized controlled trials, eight were quasiexperimental designs, and two were single-case investigations. Some programs focused only on memory, whereas other programs used multifaceted approaches targeting two or more cognitive functions. Eight were offered in groups, and seven took place on an individual basis. Recommendations to improve cognitive interventions in MCI-A are proposed, such as using large samples and a robust experimental design, as well as the implementation of a standardized cognitive training manual. Well standardized and validated direct and indirect measures of efficacy and noncognitive outcomes are also a crucial issue. A consensus meeting among all the experts working on cognitive training in this population should occur to provide guidelines to improve this treatment option.

Considering the high risk for amnestic mild cognitive impairment (A-MCI) individuals to progress towards dementia, it is crucial to study the efficacy of innovative treatment strategies such as cognitive stimulation techniques. The present study is a case report of two individuals presenting with A-MCI who were enrolled in a memory training program. After a broad neuropsychological assessment, the two participants were trained with an errorless (EL) learning paradigm on an individual basis, twice a week, over three weeks. Two follow-up sessions took place one and five weeks after the end of the training. Results showed that the program was well tolerated and feasible, and enhanced daily memory abilities. For the second participant only, a re-evaluation of her cognitive profile was completed 23 months after her first assessment and training. In addition, EL was directly compared with a control condition using an errorful (EF) learning paradigm to teach her new names over two sessions (one session for each condition). Her improvement on the trained material supported the preliminary efficacy of EL compared with EF for learning episodic material. These results are compatible with previous work that has preliminarily demonstrated the efficacy of an EL paradigm in patients with dementia.

Introduction In vitro fertilisation (IVF) is the treatment of choice for unexplained infertility. Preovulatory uterine flushing could reduce intrauterine debris and inflammatory factors preventing pregnancy and constitute an alternative to IVF. Our objective is to assess the efficacy of preovulatory uterine flushing with physiological saline for the treatment of unexplained infertility. Methods and analysis We will perform a randomised controlled trial based on consecutive women aged between 18 and 37 years consulting for unexplained infertility for at least 1 year. On the day of their luteinising hormone surge, 192 participants will be randomised in two equal groups to either receive 20 mL of physiological saline by an intrauterine catheter or 10 mL of saline intravaginally. We will assess relative risk of live birth (primary outcome), as well as pregnancy (secondary outcome) over one cycle of treatment. We will report the side effects, complications and acceptability of the intervention. Ethics and dissemination This project was approved by the Ethics committee of the Centre Hospitatlier Universitaire de Quebec (no 2015–1146). Uterine flushing is usually well tolerated by women and would constitute a simple, affordable and minimally invasive treatment for unexplained infertility. We plan to communicate the results of the review by presenting research abstracts at conferences and by publishing the results in a peer-reviewed journal. Trial registration number NCT02539290; Pre-results.

Background Sonographic evaluation of the lower uterine segment was undertaken to study the degree of thinning and, thus, to predict uterine rupture. However, the best measuring technique and recommended cutoff values remain controversial. Case Sonographic evaluation of the lower uterine segment at 36 weeks of gestation in a 31-year-old patient with prior low transverse cesarean delivery revealed a full thickness of 3.6 mm and a myometrial layer of 1.1 mm. Nevertheless, the patient experienced a large uterine rupture during a trial of labor at term. Conclusion In this case, there was a discrepancy between the full thickness and the myometrial layer, which could be representative of the lower uterine segment resistance. Such a case emphasizes the need for a consensus on sonographic measuring techniques for the prediction of uterine rupture.

The expression and function of discoidin domain receptor 1 (DDR1) in T cells are still poorly explored. We have recently shown that activation of primary human T cells via their T cell receptor leads to increased expression of DDR1, which promoted their migration in three-dimensional collagen. In the present study, we provide evidence that activated T cells bind collagen through DDR1. We found that the DDR1:Fc blocking molecule significantly reduced the ability of activated T cells to bind soluble biotinylated collagen. However, DDR1:Fc had no impact on the adhesion of activated T cells to collagen and overexpression of DDR1 in Jurkat T cells did not enhance their adhesion. Together, our results indicate that DDR1 can promote T cell migration without enhancing adhesion to collagen, suggesting that it can contribute to the previously described amoeboid movement of activated T cells in collagen matrices. Our results also show that CD28, in contrast to IL-2 expression, did not costimulate the expression of DDR1 in primary human T cells. Using specific inhibitors, we demonstrated that TCR-induced expression of DDR1 in T cells is regulated by the Ras/Raf/ERK MAP Kinase and PKC pathways but not by calcium/calcineurin signaling pathway or the JNK and P38 MAP Kinases. Thus, our study provides additional insights into the physiology of DDR1 in T cells and may therefore further our understanding of the regulatory mechanisms of T cell migration.

This study aimed to determine the efficacy of cognitive training in a 10-week randomised controlled study involving 22 individuals presenting with mild cognitive impairment of the amnestic type (MCI-A). Participants in the experimental group (n = 11) learned face-name associations using a paradigm combining errorless (EL) learning and spaced retrieval (SR) whereas participants in the control group (n = 11) were trained using an errorful (EF) learning paradigm. Psycho-educational sessions on memory were also provided to all participants. After neuropsychological screening and baseline evaluations, the cognitive training took place in 6 sessions over a 3-week period. The post-training and follow-up evaluations, at one and four weeks respectively, were performed by research assistants blind to the participant's study group. The results showed that regardless of the training condition, all participants improved their capacity to learn face-name associations. A significant amelioration was also observed in participant satisfaction regarding their memory functioning and in the frequency with which the participants used strategies to support memory functions in daily life. The absence of difference between groups on all variables might be partly explained by the high variability of scores within the experimental group. Other studies are needed in order to verify the efficacy of EL learning and SR over EF in MCI-A.

Objective This study aimed to evaluate the impact of anesthesia on the absorption of glycine in operative hysteroscopy. Study Design A retrospective cohort study was performed over 2 years. The absorption of glycine was compared among general anesthesia, local anesthesia with intravenous sedation, and spinal anesthesia. Multiple logistic regression analyses were performed. Results In all, 282 operative hysteroscopies were reviewed. The median absorption was 145 mL (10th-90th centile: 0-963 mL) for general anesthesia, 35 mL (10th-90th centile: 0-389 mL) for local anesthesia, and 100 mL (10th-90th centile: 0-500 mL) for spinal anesthesia ( P = .002). In comparison with general anesthesia, local anesthesia was associated with lower rate of absorption of 500-1000 mL (4.2% vs 13.4%) and of 1000-1500 mL (3.6% vs 9.8; P = .002). Laparoscopic tubal ligation performed during the procedure was also associated with higher glycine absorption (odds ratio, 3.63; 95% confidence interval, 1.12-11.84). Conclusions Local anesthesia with sedation is associated with significantly decreased glycine absorption and lower rate of absorption > 500 mL when compared with general anesthesia.

Operative hysteroscopy requires the use of a distension medium and its absorption can lead to serious consequences from intravascular volume overload and water intoxication. We compared the impact of 2 types of anesthesia (general anesthesia and local anesthesia with sedation) on the absorption of glycine solution in operative hysteroscopy.A randomized controlled trial was conducted over a 17-month period. Eligible patients undergoing operative hysteroscopy for abnormal uterine bleeding were randomized in 2 groups: a general anesthesia group and a local anesthesia with sedation group. The primary outcome was the median absorption of the glycine solution (10th-90th percentile) measured with an automated tandem canister system. Secondary outcomes included incidence of absorption1000 mL, discontinued surgery because of excessive absorption, median change in serum sodium, postoperative hyponatremia, and patients' postoperative quality of life at 24 hours (8-item Short Form Health Survey questionnaire). Nonparametric analyses (Mann-Whitney U test, χ(2) test, and Fisher exact test) were used.Of 142 eligible patients, 95 agreed to participate and were randomized. Women who underwent general anesthesia had a higher median absorption of the glycine solution (10th-90th percentile) compared with women who underwent local anesthesia with sedation (480 mL [76-1300 mL] vs 253 mL [70-728 mL]; P = 0.005). General anesthesia was also associated with a higher rate of glycine solution absorption (1000 mL [20% vs 4%; P = 0.009]) and a more rapid rate of decrease in serum sodium (≥10 mEq/L [8% vs 0%; P = 0.005]) than local anesthesia with sedation. Postoperative quality of life measures as rated by the patients were comparable between the 2 groups.Compared with general anesthesia, local anesthesia with sedation is associated with less glycine absorption and should be considered the preferred method of anesthesia for operative hysteroscopy.

Background: Hysterosalpingosonography has been suggested as a less invasive alternative to hysterosalpingography for detecting tubal occlusion among subfertile women. We aim to determine the diagnostic accuracy of hysterosalpingosonography and to compare it to hysterosalpingography. Methods/design: We will conduct a systematic review of diagnostic test accuracy. We will search Medline, Embase, Cochrane Library, Web of Science and Biosis, as well as reference lists of included studies and previous related review articles. Diagnostic studies that compared hysterosalpingosonography ± hysterosalpingography to laparoscopy with chromotubation in women suffering from subfertility will be eligible. Two authors will independently screen for inclusion, data extraction, and quality assessment. Methodological quality will be assessed using the Quality Assessment of Diagnostic Accuracy Study 2 tool (QUADAS-2). We will use SAS 9.3 (SAS Institute Inc., Cary, NC, USA, 2011) to program bivariate random-effects models, estimate pooled sensitivity and specificity with 95% confidence intervals and to generate summary receiver operating characteristics curves. We will perform sensitivity analyses to examine the effect of differences in techniques used for hysterosalpingosonography and in methodological quality of studies. Discussion: This systematic review will help to determine if hysterosalpingosonography is an adequate alternative screening test for diagnosing tubal occlusion. Accuracy of specific sono-HSG techniques may also be identified. Trial registration: This review has been registered at PROSPERO. The registration number is CRD42013003829.