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Objective: Premature Progesterone Rise (PPR) is characterized by elevated serum progesterone concentrations either towards the end of the follicular phase or on the trigger day, surpassing a pre-defined threshold value. Aim of the study is to evaluate the impact of PPR exceeding 1.5 ng/ml at the time of hCG-trigger on embryo morphokinetic parameters and to identify predictive biomarkers of in IntraCytoplasmic Sperm Injection (ICSI) cycles outcomes. Methods: It is a retrospective study including patients underwent ICSI cycles in the period 2020–2023. 58 patients were recruited in the study group showing P levels in the trigger day greater than or equal to 1.5 ng/ml. A matching control group of 58 patients with P levels below 1.5 ng/ml was after selected. The general characteristics of these patients, including age, Body Mass Index (BMI), antral follicle count (AFC), anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels, the type of infertility and smoking/non-smoking patients, were recorded on the day of their initial visit. Subsequently, data were collected regarding the number of eggs retrieved, mature eggs, successfully fertilized eggs, and embryos reaching the blastocyst stage. Additionally, the timing of embryonic development and the quality of obtained blastocysts, as assessed by the degree of expansion and the characteristics of the inner cell mass (ICM) and trophectoderm (TE), were evaluated using Time-Lapse technology. Results: Elevated P levels exceeding 1.5 ng/ml on the trigger day were directly associated with a significantly larger number of antral follicles, consequently leading to a higher count of retrieved eggs, mature eggs, successfully fertilized eggs and embryos reaching the blastocyst stage. Furthermore, the analysis of morphokinetic parameters indicated faster division times and a notably greater number of high-grade blastocysts in the study group compared to the control group. Conclusions: P levels ≥ 1.5 ng/ml on the trigger day did not negatively impact embryonic morphokinetic parameters, instead resulting in faster embryo development in the initial stages. [ABSTRACT FROM AUTHOR]

Blood flow in the calf was measured during postexercise hyperemia in normal subjects and in PAD patients by means of a foot ergometer that gives direct reading of the work performed. In normals, first and peak flow increased with the rise of work load up to 100 KGM. The duration of hyperemia increased with a work load of 30 to 200 KGM. In PAD patients, first flow did not coincide with peak flow. Peak flow was lower and delayed, and the duration of hyperemia was more prolonged than in normal subjects. In patients with intermittent claudication, first flow, peak flow, and work load were higher than in patients with rest pain or impending gangrene. Exercise hyperemia appears as a useful test for screening normal limbs from those with arterial obstruction. Since in PAD patients exercise is interrupted when muscular pain appears, it is evident that the earlier the arrest of work and the appearance of pain, the greater is the involvement in the arterial tree of the leg. Therefore the exercise hyperemia test can be used also as a means of evaluating the different stages of PAD. [ABSTRACT FROM AUTHOR]

To test the hypothesis of a myofascial component in intermittent claudication, 56 male patients were studied. Calf blood flow, at rest and during postischemic and postexercise hyperemia, presence of trigger areas, and exercise tolerance were evaluated and compared. The results can be summarized as follows: The exercise tolerance is reduced when trigger areas are present in the calf muscles, and the more severe the trigger areas, the lower is the exercise tolerance. Trigger areas are more severe when the hyperemic flow is more reduced. The peak flow of reactive hyperemia is also correlated to work load. Pain in intermittent claudication is a complex phenomenon. According to the aforesaid results, the severity of limb ischemia and the presence of trigger areas in the calf appear to be the major factors. Besides the two reasons already known, a third is suggested to explain calf claudication: the elective location of trigger points in the gastrocnemius muscle. [ABSTRACT FROM AUTHOR]

Reactive and exercise hyperemia were compared in healthy men and in patients with PAD. In both patients and normals the calf blood flow of reactive hyperemia was recorded after a 5-minute ischemia. Exercise hyperemia was measured in normals after variable work loads (30 and 50 kg) and immediately after the occurrence of pain in patients with PAD. In healthy limbs the first and peak flows of exercise and reactive hyperemia are similar. The recovery time For basal flow is prolonged alter exercise. However, reactive and exercise hyperemia differ significantly when arterial obstruction due to arteriosclerosis obliterans is present. First flow and peak flow are higher and recovery time more prolonged alter exercise. It is also likely that the control mechanisms of the two hyperemic reactions arc different. Muscular exercise, when protracted until pain occurs, can produce a metabolic and circulatory adjustment other than that of ischemia. There is experimental evidence to support this hypothesis. [ABSTRACT FROM AUTHOR]

To study the rheological properties of blood at rest and after ischemia or exercise, we performed 16 experiments on 14 normal subjects and 19 on 19 patients with PAD. The blood drawn from an antecubital vein at rest and after ischemia or exercise was used immediately for the following tests: erythrocyte filtration through Millipore filters, blood viscosity at high shear rates, red cell values, microhematocrit, and blood gas analysis. A 15-minute period of ischemia does not affect the main rheological properties of blood flowing in the antecubital veins during reactive hyperemia. On the other hand, muscular exercise greatly alters the blood flowing in the forearm that performed the work, both in normal subjects and in patients with PAD. Blood viscosity is increased at high shear rates. MCV and hematocrit rise significantly. Venous pCO2 rises and venous pH is lowered. The increased blood viscosity at high shear rates can be explained by the rise of hematocrit and the possible rigidification of red cells. This rigidification could be produced by the changes in blood pH and osmolality caused by muscular work. [ABSTRACT FROM AUTHOR]

The best-fit method was applied to data of calf basal resting and reactive hyperemia blood flow, recorded at 4-hr, intervals during a day in 15 patients with intermittent claudication. The mathematical-statistical analysis suggests existence of a circadian rhythm of calf blood flow, which has early evening peaks and a nocturnal trough with a nadir occurring after midnight and before 4 a.m. This rhythm displays marked similarities to those of all other circulatory values. It is hard to decide whether or not the mechanism of rhythm has an independent endogenous origin. It is known that many of the circulatory variables are interrelated and that some are clearly related to other circadian rhythms. Perhaps the rhythmic reduction of limb blood flow, which begins during the night, is the mechanism underlying the nocturnal pain of subjects with limb ischemia by peripheral arterial disease. [ABSTRACT FROM AUTHOR]