Jessica Aidee Mora-Galvan

Background/Objective: Asherman syndrome is an acquired intrauterine adhesive disorder associated with menstrual abnormalities, infertility, recurrent pregnancy loss, and adverse reproductive outcomes. Data from Latin American tertiary referral centers remain limited. To characterize clinical history, classification, hysteroscopic management strategies, and anatomical and reproductive outcomes in a single cohort of Mexican women with Asherman syndrome. Methods: This retrospective cohort study included women identified through institutional electronic records between July 2016 and December 2023 with a diagnosis of Asherman syndrome and analyzable hysteroscopic records. Women were followed for twelve months. Recurrence was defined as hysteroscopic evidence of intrauterine adhesions during follow-up. Among women with follow-up hysteroscopy, two-sided Fisher’s exact tests were used to calculate odds ratios and 95% confidence intervals. Results: Fifty-four women were analyzed. A prior uterine procedure was documented in 44 women (81.5%), with sharp curettage in 35 (64.8%). The most common reasons for consultation were secondary infertility (29.6%), abnormal uterine bleeding (27.8%), primary infertility (20.4%), and recurrent pregnancy loss (13.0%). Disease severity was classified as mild in 30 women (55.6%), moderate in 11 (20.4%), and severe in 7 (13.0%). Hysteroscopic intervention was predominantly performed with cold knife adhesiolysis (83.3%). Twelve-month follow-up hysteroscopy was performed in 38 women (70.4%); recurrence was identified in 30 (55.6%). Among the 34 women with reproductive intent, 12 achieved a live birth, corresponding to a live birth rate of 35.3%. Conclusions: Prior uterine instrumentation, particularly sharp curettage, was the most frequent antecedent. Recurrence remained common despite surgical management, highlighting the need for standardized postoperative surveillance and preventive strategies.

According to the WHO, COVID-19 is transmitted mainly between people through contact, derived from droplets that occur in an individual who manifests respiratory symptoms. These droplets can come from the mucus (mouth and nose) or conjunctiva (eyes), having a diameter between 5 to 10 micrometers. As a consequence of it, there is high contagion rate presented by this virus, making essential that health personnel in contact with these patients wear highly specialized protective equipment, this has led to a shortage of these products worldwide. This paper presents the design, development and validation of a health personnel protection system which consists of a diving mask, an adapter made in 3D printing (additive manufacturing) and a bidirectional High Efficiency Particulate Air filter. Protocols for cleaning, sterilization and management of the device components are also presented. The personal protective equipment was tested in the Intensive Care Unit for COVID-19 patients from the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran at Mexico City.