Highlights • First 3-year longitudinal data regarding the clinical performance of RealTime assay. • Accumulation of CIN2+ predominantly in woman with normal cytology at baseline. • Negative HPV ...results show better protection than normal cytology over 3 years. • Concurrent genotyping for HPV16/18 useful as triage of hrHPV-positive women. • RealTime can be safely used in primary cervical cancer screening.
Embryo culture media are important factors in IVF, which can significantly influence clinical outcome of IVF/ICSI cycles. Despite this, it is still not completely clear which formulation is most ...optimal and whether sequential or continuous media should be favored.
This study retrospectively analyzed the outcome of IVF/ICSI cycles with regard to different types of culture media used to culture embryos, namely sequential and two types of single step continuous embryo culture media.
If the data were combined for both types of single step continuous embryo culture media the only significant difference we observed was the proportion of poor quality embryos on day 3, which was significantly higher (16.9% vs. 22.5%; P = 0.017) in the sequential media. The pregnancy (55.1% vs. 40.5%; P = 0.113) and live birth rates (42.9% vs. 33.8%; P = 0.308) were lower in continuous media, although the difference was not statistically significant. Furthermore, the blastocyst rate (sequential vs. continuous; 47.4% vs. 47.3%; P = 1), and birthweight (3280 ± 630g vs. 3272 ± 575g; P = 0.96) did not significantly differ regardless of the medium used to culture embryos. Additional comparison of each type of continuous medium to sequential media revealed that the difference in the quality of cleavage stage embryos for combined data of both continuous culture media may be derived from the group of cycles were SAGE 1-Step was used to culture embryos.
These results therefore indicate that continuous media can be equivalent to sequential media and could help lower the workload in busy IVF labs without impairing the clinical results. Although, caution is needed because this study is limited by its retrospective design. To confirm the results, especially in terms of live birth rates and perinatal outcome, a prospective study is needed with a higher number of included couples.
The latest reports suggest that it is better to transfer embryos to the uterus on day five of preimplantation development compared to other days of development, but it is not clear if this stands ...when there are only one-two embryos obtained in the cycle. Therefore, to address this issue, we performed a retrospective study of such cycles. Our study included all of the stimulated IVF/ICSI cycles performed at our institution in the period between 1 January 2004 and 31 December 2018 in which one-two embryos were obtained in the IVF/ICSI cycle and met our inclusion criteria, and we compared the data between day three and day five embryo transfer (ET). The analysis revealed that the day three ET group of patients was significantly older (
< 0.001), were administered a significantly higher dose of gonadotrophins (
= 0.015), and retrieved a lower mean number of aspirated oocytes per cycle (
< 0.001) and lower mean number of embryos (
< 0.001). The birth rate per ET was significantly higher in the day five ET group (
= 0.045) and further analysis indicated that this could be due the trend observed in a group of patients under 36 years old, while in older patients there was no such difference. To conclude, our retrospective study indicates that it might be better to perform ET on day five instead of day three when there are only one-two embryos obtained in the cycle, but probably only when patients are under 36 years old.
The aim was to establish the impact of human granulosa cell apoptosis and reactive oxygen species (ROS) production on fertilization competence of the oocyte, embryo developmental stage and ...implantation rate.
Thirty women undergoing IVF-ET for tubal factor infertility were included; GnRH antagonists and gonadotrophins were used for ovarian stimulation. Granulosa cells were isolated from each aspirated follicle using gradient centrifugation. Apoptosis was studied by flow cytometry using annexin V and propidium iodide. ROS production was studied with hydroethidine staining and analyzed by flow cytometry.
There were no differences in characteristics of granulosa cells between the follicles with fertilized and non-fertilized oocytes. The analyzed characteristics of granulosa cells in corresponding follicles had no effect on embryo developmental stage on day 5. The percentage of ROS producing granulosa cells was lower in the follicles giving rise to blastocysts that resulted in implantation compared to those that did not (39.9% versus 69.9%, P = 0.031).
Apoptosis and ROS production in granulosa cells have no significant impact on fertilization and do not correlate with the development of blastocysts. An increased percentage of ROS producing granulosa cells results in fewer oocytes retrieved and diminishes implantation rate.
Background: The study sought to determine whether hepatitis B infection in females and males plays a role in the outcome of the IVF/ICSI cycle. Methods: We performed a retrospective analysis of data ...collected from IVF/ICSI cycles carried out from January 2011 to December 2019 at the University Medical Centre Ljubljana. The data was analyzed using Pearson’s chi-square test, Fisher’s exact test, and Kruskal-Wallis test in order to determine the differences between the groups. Results: This study included 117 cycles with a past female hepatitis B infection (HF group), 91 cycles with couples with a past male hepatitis B infection (HM group), and 10,216 cycles with no past male or female hepatitis B infection (control group). There was no difference in sperm concentration, but total sperm motility was significantly higher in the HF and control groups compared to the HM group (p = 0.008 and p < 0.001). Also, sperm morphology was significantly higher in the control group, compared to both, the HM group (p < 0.001) and the HF group (p = 0.004). Furthermore, the rate of fertilized oocytes per number of retrieved oocytes was significantly higher in the HF (p < 0.001) and control groups (p = 0.003) compared to the HM group, but on the contrary, the rate of immature oocytes was lower in the HM (p = 0.009) and control groups (p = 0.001) compared to the HF group. The number of obtained embryos, blastocyst, and embryo utilization rates were similar between the groups, although the rate of cryopreserved embryos was higher in the HF (p = 0.007) and the HM groups (p = 0.027) compared to the control group. No significant difference was observed in the pregnancy and live birth rate per embryo transfer, while a trend towards a lower birth rate per aspiration was observed in the HM and in HF groups, which can be explained with a significantly higher miscarriage rate observed in the HM (p < 0.001) and HF groups (p = 0.042) compared to the control group. Gestational age was similar for all groups, although we observed a strong trend towards a higher birth weight of singletons in the HF group (p = 0.043) compared to the control group. Conclusions: The results indicate that hepatitis B infection could have a detrimental influence on sperm motility and morphology and cycle outcome, especially in terms of a higher miscarriage rate.
Syphilis is a sexually transmitted disease caused by spirochete
, with a growing incidence documented in recent years. Its clinical course is divided into three phases - primary, secondary, and ...tertiary syphilis - and virtually any organ can be affected, resulting in diverse clinical manifestations, making the diagnosis challenging. Neurosyphilis is a progressive, destructive disease of the central nervous system (CNS) that can develop at any stage of the infection, leading to meningeal involvement, meningovascular disease, or parenchymal syphilis (including tabes dorsalis and general paresis). Its clinical manifestations are heterogeneous and vary from focal neurologic signs to neuropsychiatric manifestations. The diagnosis is based mainly on the clinical picture and study of cerebrospinal fluid. Neuroimaging is helpful and sometimes essential, with magnetic resonance imaging being the most sensitive radiologic method, although there are no pathognomonic radiologic signs. Treatment of all forms of neurosyphilis is based on parenteral penicillin. We present a case of neurosyphilis in a patient presenting with a subacute confusional state and initial imaging findings suggestive of metastatic CNS lesions.
Kala-Azar: A Case Report Jancar, Nina; Sousa Gonçalves, Filipa; Duro, José ...
Curēus (Palo Alto, CA),
02/2023, Letnik:
15, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Leishmaniasis is a zoonosis caused by unicellular protozoans
. The transmission can be zoonotic or anthroponotic, depending on the species, and the main vector is the phlebotomine sandfly. The ...disease is endemic in the tropics of Asia and Africa but is considered rare in Portugal, especially in immunocompetent hosts. Its main clinical syndromes constitute cutaneous leishmaniasis, mucocutaneous disease, and visceral leishmaniasis. The latter is also known as
and is caused by the infection of the phagocytes of the reticuloendothelial system, causing the typical symptoms: fever, hepatosplenomegaly, and pancytopenia. The clinical manifestations are non-specific, frequently causing a delay in the diagnosis, especially in nonendemic areas and immunocompetent hosts. Early diagnosis and treatment are essential, given the high mortality rate in untreated patients. The diagnosis is based on the direct visualization of the protozoan and molecular methods, such as polymerase chain reaction tests. Amphotericin B is considered the first-line treatment. We present a case of visceral leishmaniasis in an immunocompetent patient with fever, hepatosplenomegaly, and pancytopenia.
Hemophagocytic lymphohistiocytosis (HLH) is an acute, rare systemic hyperinflammatory disorder caused by a dysregulated immune cell function and massive cytokine release, often leading to multiple ...organ involvement and failure. Fever, hepatosplenomegaly, cytopenia, elevated liver enzymes, hypertriglyceridemia, and hyperferritinemia are the hallmarks of the disease. Its primary (genetic) form is typically observed in pediatric patients and its secondary, acquired form is seen in adult patients with an underlying autoimmune, malignant, or infectious disease. It is not frequently reported in patients with chronic lymphocytic leukemia (CLL) without an infectious or pharmacological trigger. We present a case of a 71-year-old patient with hemophagocytic lymphohistiocytosis due to the progression of chronic lymphocytic leukemia.
Progressive multifocal leukoencephalopathy is a rare, progressive demyelinating disease of the central nervous system caused by reactivation and replication of the John Cunningham (JC) virus in ...cerebral oligodendrocytes. The JC virus is a small ubiquitous polyomavirus that can be detected in up to 50% of the adult population. It affects almost exclusively immunocompromised patients and is generally observed in patients with acquired immunodeficiency syndrome and patients with hematologic malignancies and autoimmune or chronic inflammatory diseases medicated with immunosuppressive and immunomodulatory drugs. However, it is rarely described in patients with hematologic malignancies, not undergoing chemotherapy or immunosuppressive therapy. It has a poor prognosis, and the treatment is based on restoring the immune system, given that no specific antiviral treatment is available. We present a case of a chemotherapy-naive patient with chronic lymphocytic leukemia associated with progressive multifocal leukoencephalopathy.
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