Alterations in body temperature may be frequently observed in patients and experimental animals. Systemic infections may alter the host body temperature, and a pre-existing altered body temperature may modulate the host response to infection. Septic patients who develop hypothermia have a significantly worse outcome than those who develop a fever or maintain a normal body temperature. Perioperative hypothermia may occur as a result from anesthetic action, surgical procedures, or specific targeted interventions. This perioperative hypothermia is associated with adverse outcomes including increased surgical wound infections. In animal models of sepsis, perioperative hypothermia is also associated with a worse outcome and specific alterations of the inflammatory response. Understanding the mechanisms of why the host response to infection is impaired by pre-existing hypothermia will both improve our basic understanding of disease as well as identify potential targets for modulation.

Resumen Los autores presentan un caso de hematoma subcapsular roto y del cuarto segmento del hígado en una mujer de 26 años, en la semana 36 del embarazo, complicada por preeclampsia. Los signos clínicos de preeclampsia se asociaron con dolor en el hipocondrio derecho y hallazgos de laboratorio compatibles con un verdadero síndrome HELLP. Se realizó una laparotomía de emergencia con rotura hepática y hemoperitoneo. Se realizó una cirugía de control de daños, con drenaje de hemoperitoneo, packing hepático y uso de una bolsa de Bogotá. El desempaque se realizó a las 24 horas y la colocación de la terapia de VAC asociada con la malla con el posterior cierre de la fascia dentro de los 10 días. Se presentan diferentes opciones terapéuticas que incluyen intervenciones médicas, quirúrgicas y radiológicas. No se puede definir una estrategia única. El enfoque multidisciplinario parece obligatorio. La cirugía debe permanecer lo menos agresiva posible.

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gonadotropins, an additional 0.88 twin pregnancies occurred. Singleton birth per cycle was similar between the two groups. The results did not change in per protocol, per cycle, or fix effect model sensitivity analyses.CONCLUSIONS: Gonadotropin use in women with unexplained infertility did not increase the likelihood of live birth. For every birth gained with the use of gonadotropins, an almost identical increase in the risk of twins occurs. The randomized data do not support the use of gonadotropins for superovulation in women with unexplained infertility.

DESIGN: prospective randomized controlled trial. MATERIALS AND METHODS: A total of 60 low responder, who were defined as patient who failed to produce <3 follicles with a mean diameter of < 16 mm with the result that <3 oocytes were retrieved despite the use of a high gonadotropin dose in a previous failed IVF/ICSI cycle from 1.1.18 to 31.3.19 (15 months). Patient were randomized into TTG pretreatment group and control group. For TTG pretreatment group, 12.5mg TTG were applied daily for 21 days in the cycle preceding COS for IVF.RESULTS: There were no differences in patients characteristics between the two group. Total dose of FSH used were significantly fewer in the TTG pretreatment group than in the control group. The number of oocytes retrieved , mature oocytes, fertilized oocytes, and good quality embryos were significantly higher in the TTG pretreatment group. Embryos implantation rate and clinical pregnancy rate per cycle also were significantly higher in the women pretreated with TTG. No patient reported adverse effects attributed to TTG use.CONCLUSIONS: TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI. (fertil steril 2011;95:679-83. 2011 by American society for reproductive medicine).