Imaging modalities play a crucial role in the management of suspected COVID-19 patients. Before reverse transcription polymerase chain reaction (RT-PCR) test results are positive, 60-93% of patients have positive chest computed tomographic (CT) findings consistent with COVID-19. We report a case of positive lung ultrasound findings consistent with COVID-19 in a woman with an initially negative RT-PCR result. The lung ultrasound-imaging findings were present between the negative and subsequent positive RT-PCR tests and correlated with CT findings. The point-of-care lung-ultrasound examination was easy to perform and, as such, could play an important role in the triage of women with suspected COVID-19. The neonatal swabs, cord blood and placental swab RT-PCR tests were negative for SARS-CoV-2, a finding consistent with the published literature suggesting no vertical transmission of this virus in pregnant women.

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Case presentation An 81-year-old woman (gravida 2, para 2) was referred on April 2019 to the Gynecologic Oncology Unit of San Gerardo Hospital from another institution for symptomatic utero-vaginal prolapse and foulsmelling discharge with concomitant bleeding. The clinical examination revealed a stage IV utero-vaginal prolapse (cervix and uterus have both descended outside introitus) and concomitant friable velvet tumor involving almost all the anterior and lateral sides of the vaginal walls with no macroscopic infiltration of the atrophic cervix (Figure 1). She reported frequency of urination, with associated incomplete emptying of the bladder without urinary incontinence. Preoperative urodynamic evaluation demonstrated post-void residuals>150 mL. At presentation, her weight was 40 kilograms and she had evidence of nutritional deficiency. She had a history of chronic hypertension, recurrent urinary tract infections, and chronic venous insufficiency. The biopsy of the vaginal wall tumor performed prior to her presentation showed a moderately differentiated invasive squamous cell carcinoma. Pelvic evaluation was negative and no palpable groin nodes were present. Work-up included chest X-ray, urodynamic evaluation, a pelvic MRI, and PET/CT scan. Dr perego Can you describe the Mri and pet/Ct imaging results? At MRI scan, the T1, T2-weighted, and DWI sequences and paramagnetic contrast (PROHANCE macrociclic,

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Study question What is the effect of endometrial compaction on live birth rate in frozen-thawed embryo transfer (FET) cycles? Summary answer In FET cycles with artificial endometrial preparation, the chance for live birth was significantly higher in cycles with endometrial compaction. What is known already Most studies conclude that thinner the endometrium poorer the pregnancy outcome. These studies mostly include measurements in the follicular phase. Since endometrial thickness indicates receptivity, one may expect the endometrial thickness measured on ET day to be more important to predict the outcome. However, few studies assessed endometrial thickness on ET day and unlike follicular phase studies conflicting results were obtained regarding pregnancy outcome. The change in endometrial thickness may be more valuable to predict the pregnancy outcome rather than a single measurement. Study design, size, duration Retrospective observational cohort study. 283 FET cycles in which all patients underwent artificial endometrial preparation were reviewed. Participants/materials, setting, methods: The inclusion criteria were artificial endometrial preparation, age between 20–38 years. The same protocol was applied to all patients for the endometrial preparation.The change of endometrial thickness between the end of estrogen phase and embryo transfer day was recorded. Any decrement is defined as endometrial compaction. The patients were grouped according to the changes of endometrial thicknesses as compaction and non-compaction. Main results and the role of chance Among 283 cycles, 89 had endometrial compaction and 194 did not have compaction. The clinical pregnancy, implantation and live birth rates were significantly higher in the compaction group when compared to non-compaction group (P values 0.007, 0.009, and 0.039, respectively). In order to evaluate the results according to the degree of compaction, we divided the patients into 5% compaction slices. The live birth rate was significantly higher in the 5–10% compaction group (P = 0.016). A multivariable logistic regression analysis was performed to examine the independent effects of different variables on live birth chance.In FET cycles with artificial endometrial preparation, the chance for live birth was significantly higher in cycles with endometrial compaction (OR: 2.352, 95% confidence interval {CI} 1.297–4.264, P = 0.005). A receiver operating characteristic (ROC) curve analysis was performed to evaluate whether there was a certain threshold of endometrial thickness at the end of estrogen phase for endometrial compaction to occur. The sensitivity and specificity of 9.25 mm at the end of estrogen phase calculated from the ROC curve were 76.4% and 58.8%, respectively (area under the curve: 0.701, 95% CI 0.640–0.763; P < 0.001). Limitations, reasons for caution The main limitations of the study were its retrospective nature, relatively small sample size and utilization of different ultrasound techniques at different measurements (using transvaginal ultrasound at the end of the estrogen phase and transabdominal ultrasound on ET day). Wider implications of the findings: Recently a cohort study they found that endometrial compaction results in better pregnancy outcomes, similar to our findings. But, this is the first study to suggest a threshold value (9.2) for endometrial thickness before the commencement of progesterone in regards to increase the chance of compaction. Trial registration number Not applicable

There is an urgent need for individuals with mild to moderate COVID-19 pneumonia to learn and apply the recommended interventions for pulmonary rehabilitation. In the health literature, various studies showed that mobile health (m-health) applications play an important support role in managing health and coping with diseases. However, there is no m-health application yet for pulmonary rehabilitation specifically designed for COVID-19 patients. This chapter reports the development of “Covid Breathe” and its evaluation in terms of feasibility, safety, and effectiveness. A hundred patients with mild to moderate pneumonia were randomly assigned to control and intervention groups. While 88% of the patients reported being very satisfied with the m-health application, no statistical difference in patient satisfaction between the groups was reported. Nevertheless, there was a statistically significant improvement in Modified Borg Scale, Dyspnea Score, and Hospital Anxiety and Depression Scale parameters. The usage of this m-health app is therefore recommended for pulmonary rehabilitation.

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