ATAK Complex due to Amoxicillin: A Case Report Alarcón Gallardo, E; Escudero Apesteguía, R; Sanz Bescós, C
Journal of investigational allergology & clinical immunology,
01/2024, Volume:
34, Issue:
1
Journal Article
STUDY QUESTION
Is the live birth rate (LBR) per embryo thawed/warmed higher when Day 3 cleavage stage embryos are cryopreserved by vitrification compared with slow freezing?
SUMMARY ANSWER
The LBR ...per embryo thawed/warmed was higher after vitrification than after slow freezing on Day 3, based on better embryo survival, quality and availability of embryos in the vitrification group.
WHAT IS KNOWN ALREADY
Post-thawing survival rate of cleavage-stage embryos has been reported to be higher after vitrification than after slow freezing.
STUDY DESIGN, SIZE, DURATION
This RCT was performed in an academic tertiary center between September 2011 and March 2013. If supernumerary embryos were available on Day 3, patients were randomized at the time of cryopreservation using a computerized system to determine a simple allocation to the vitrification group or the slow freezing group and all embryos were frozen with the same technique. The primary outcome of this study was the LBR per embryo thawed/warmed. Power calculation revealed that 184 thawed embryos were needed in each group (β = 0.8, α < 0.05) to test the hypothesis that the LBR per embryo thawed/warmed was significantly higher (16%) after vitrification than after slow freezing (6%).
PARTICIPANTS/MATERIALS, SETTING, METHODS
Patients <40 years old undergoing their first oocyte retrieval (OR), with embryo transfer and with supernumerary embryos on Day 3, were randomized. Day 3 embryos with ≥6 cells, <25% fragmentation and morphologically equal blastomeres were cryopreserved by slow freezing (using 1,2-propanediol and 0.1 M sucrose as cryoprotectant) or by closed vitrification using commercially available freezing/vitrification media. Survival was defined as ≥50% cells were intact after thawing. Thawed embryos were further cultured overnight. In total, 307 patients were randomized to slow freezing (155 patients, 480 embryos) or vitrification (152 patients, 495 embryos).
MAIN RESULTS AND THE ROLE OF CHANCE
By March 2013, 200 embryos were thawed after slow freezing in 95 cycles for 79 patients and 217 embryos were warmed after vitrification in 121 cycles in 90 patients. The LBR per embryo thawed/warmed was significantly higher after vitrification (16.1% (35/217)) than after slow freezing (5.0% (10/200); P < 0.0022; relative risk (RR) 3.23; 95% confidence interval (CI) 1.64–6.35). Similarly, the implantation rate per embryo thawed/warmed was higher after vitrification (20.7% (45/217) than after slow freezing (7.5% (15/200); P = 0.0012; RR 2.76; CI 1.59–4.81). The survival rate was significantly higher after vitrification (84.3% (183/217) than after slow freezing (52.5% (105/200); P < 0.0001). Significantly more embryos were fully intact after vitrification (75.4% (138/183) than after slow freezing (28.6% (30/105); P < 0.0001). The number of transfers was significantly higher after vitrification (90.1% (109/121)) than after slow freezing (73.7% (70/95); P = 0.0024).
LIMITATIONS, REASONS FOR CAUTION
Survival rates in the slow freezing group were low in this study. Additional RCTs are needed to compare reproductive outcome after vitrification and after slow freezing with 1,2-propanediol and 0.2 M sucrose, since this method has been reported to have better survival than the method used in our study. Our findings are only applicable to the specific slow freezing cryopreservation medium used in our study, and not to any other commercially available media.
WIDER IMPLICATIONS OF THE FINDINGS
When compared with slow freezing using 1,2-propanediol and 0.1 M sucrose as cryoprotectant, vitrification of Day 3 cleavage stage embryos resulted in a higher LBR per embryo warmed, and may therefore result into a higher cumulative delivery rate after one oocyte retrieval.
STUDY FUNDING/COMPETING INTEREST(S)
None.
TRIAL REGISTRATION NUMBER
NCT02013024.
El cáncer de vesícula biliar es una enfermedad poco frecuente en Europa y Norteamérica, por lo cual existe escasa investigación científica sobre ella. A su vez, es frecuente a lo largo de la zona ...andina de América del Sur, especialmente en Chile donde se registraron en el pasado las tasas más altas de incidencia y mortalidad del mundo. El 75% de los pacientes son mujeres, existiendo una fuerte relación con la colelitiasis, especialmente de larga data y la inflamación crónica. Casi no existe CVB sin colelitiasis. El cáncer de vesícula se asocia también estrechamente con obesidad y una dieta alta en grasa y azúcares. Es más común en algunas poblaciones nativas, especialmente la población mapuche, siendo frecuentemente asociado a un nivel socioeconómico bajo y a un menor acceso al sistema sanitario. En Chile, la tasa de mortalidad ha disminuido en más del 50% en los últimos 20 años. La colecistectomía profiláctica en la población de alto riesgo, implementada como política nacional en Chile, ha repercutido en la incidencia y la mortalidad por esta enfermedad que, por largo tiempo, fue la primera causa de muerte por cáncer en mujeres chilenas. El objetivo de este artículo es esbozar antecedentes epidemiológicos del cáncer de vesícula biliar en el mundo y en Chile y describir los factores de riesgo y medidas para su prevención.
Gallbladder cancer is a very rare disease in Europe and North America, reason why there is scarce scientific research about it. At the same time, it is very common throughout the Andean region of South America, especially in Chile which once had the highest incidence and mortality rates in the world. Women account for 75% of patients, with cases being strongly related to long standing cholelithiasis, as well as chronic infection. Gallbladder cancer rarely exists without cholelitiasis. It is also closely associated with obesity and a diet high in fat and sugar. It is more common in some native populations, especially the Mapuche population, frequently associated with a low socioeconomic level and less access to the health system. In Chile, the mortality rate decreased by more than 50% in the last 20 years. Prophylactic cholecystectomy in high-risk population, implemented as a national policy in Chile, is reducing incidence and mortality from this disease which, for a long time, was the leading cause of death by cancer in Chilean women. The objective of this article is to outline the epidemiological history of gallbladder cancer in the world and in Chile as well as describe the risk factors and measures for its prevention.
An investigation of the deactivation of pathogens using electromagnetic waves in the microwave region of the spectrum is achieved using custom-built waveguide structures. The waveguides feature ...sub-wavelength gratings to allow the integration of an air cooling system without disturbing the internal propagating fields. The waveguides are tapered to accommodate an experimental sample internally with sufficient surrounding airflow. The proposed methodology allows for precise control over power densities due to the well-defined fundamental mode excited in each waveguide, in addition to temperature control of the sample due to microwave exposure over time. Human coronavirus (HCoV-229E) is investigated over the 0-40 GHz range, where a peak 3-log viral reduction is observed in the 15.0-19.5 GHz sub-band. We conclude HCoV-229E has an intrinsic resonance in this range, where nonthermal structure damage is optimal through the structure-resonant energy transfer effect.
Rituximab has emerged as an efficacious option for drug-resistant myasthenia gravis (MG). However, reports published only describe the short-term follow-up of patients treated and little is known ...about their long-term clinical and immunologic evolution. Our objective was to report the clinical and immunologic long-term follow-up of 17 patients (6 MuSK+MG and 11 AChR+MG) and compare the response between AChR+MG and MuSK+MG patients.
Myasthenia Gravis Foundation America postintervention status and changes in treatment and antibody titers were periodically determined. Lymphocyte subpopulations, total immunoglobulin, immunoglobulin G (IgG) anti-MuSK subclasses, and anti-tetanus toxoid IgG before and after treatment were also studied.
After a mean post-treatment period of 31 months, 10 of the AChR+MG patients improved but 6 of them needed reinfusions. In contrast, all MuSK+MG patients achieved a remission (4/6) or minimal manifestations (2/6) status and no reinfusions were needed. Consequently, in the MuSK+MG group, prednisone doses were significantly reduced and concomitant immunosuppressants could be withdrawn. Clinical improvement was associated with a significant decrease in the antibody titers only in the 6 MuSK+MG patients. At last follow-up MuSK antibodies were negative in 3 of these patients and showed a decrease of over 80% in the other 3.
In view of the long-lasting benefit observed in MuSK+MG patients, we recommend to use rituximab as an early therapeutic option in this group of patients with MG if they do not respond to prednisone.
This study provides Class IV evidence that IV rituximab improves the clinical and immunologic status of patients with MuSK+MG.
In Mexico, 39.5% of adolescents do not meet the World Health Organisation's physical activity guidelines. Urbanicity is a potential correlate of physical activity. The aim of this study was to ...examine the associations between different aspects of urbanicity and adolescents' physical activity.
Participants were 4,079 Mexican adolescents aged 15-18 from Mexico City and Oaxaca, Mexico. Data was collected between February and June 2016. Multiple imputation of missing data was implemented after confirming values were missing at random. Multivariable regression models examined associations between five domains of self-reported physical activity: 1) moderate-to-vigorous physical activity, 2) sports activities, 3) leisure time activities, 4) Physical Education class at school, 5) active commuting to school; and a composite measure of urbanicity and its seven sub-scores: 1) demographic, 2) economic activity, 3) built environment, 4) communication, 5) education, 6) diversity and 7) health services. Multivariable regression models were adjusted for parents' education and participants' age.
Urbanicity was positively associated with activity spent in Physical Education class. The association between urbanicity and sport activities depended on state context. Communication-based urbanicity was negatively associated with leisure physical activity and active commuting. Population density was positively associated with active commuting.
Urbanicity is associated with adolescents' physical activity in Mexico. Findings were largely consistent between Mexico City and Oaxaca and highlight the value of examining urbanicity as a multidimensional construct.
•The method was fully validated and excellent limits of detection and quantitation using 0.25mL of sample.•The developed method is suitable for regular analysis in the field of forensic and clinical ...toxicology.•This is the first reported method for THC and metabolites in plasma using MEPS and GC/MS-MS.
Cannabis is one of the most available and consumed illicit drug in the world and its identification and quantification in biological specimens can be a challenge given its low concentrations in body fluids. The present work describes a fast and fully validated procedure for the simultaneous detection and quantification of ▵9-tetrahydrocannabinol (▵9_THC) and its two main metabolites 11-hydroxy ▵9_tetrahydrocannabinol (11-OH-THC) and 11-nor-9-carboxy-▵9- tetrahydrocannbinol (THC-COOH) in plasma samples using microextraction by packed sorbent (MEPS) and gas chromatography–tandem mass spectrometry (GC–MS/MS). A small plasma volume (0.25mL) pre-diluted (1:20), was extracted with MEPS M1 sorbent as follows: conditioning (4 cycles of 250μL methanol and 4 cycles of 250μL 0.1% formic acid in water); sample load (26 cycles of 250μL); wash (100μL of 3% acetic acid in water followed by 100μL 5% methanol in water); and elution (6 cycles of 100μL of 10% ammonium hydroxide in methanol). The procedure allowed the quantification of all analytes in the range of 0.1–30ng/mL. Recoveries ranged from 53 to 78% (THC), 57 to 66% (11-OH-THC) and 62 to 65% (THC-COOH), allowing the limits of detection and quantification to be set at 0.1ng/mL for all compounds. Intra-day precision and accuracy revealed coefficients of variation (CVs) lower than 10% at the studied concentrations, with a mean relative error within±9%, while inter-day precision and accuracy showed CVs lower than 15% for all analytes at the tested concentrations, with an inaccuracy within±8%.
There is an urgent need to identify biomarkers to guide personalized therapy in castration-resistant prostate cancer (CRPC). We aimed to clinically qualify androgen receptor (AR) gene status ...measurement in plasma DNA using multiplex droplet digital PCR (ddPCR) in pre- and post-chemotherapy CRPC.
We optimized ddPCR assays for AR copy number and mutations and retrospectively analyzed plasma DNA from patients recruited to one of the three biomarker protocols with prospectively collected clinical data. We evaluated associations between plasma AR and overall survival (OS) and progression-free survival (PFS) in 73 chemotherapy-naïve and 98 post-docetaxel CRPC patients treated with enzalutamide or abiraterone (Primary cohort) and 94 chemotherapy-naïve patients treated with enzalutamide (Secondary cohort; PREMIERE trial).
In the primary cohort, AR gain was observed in 10 (14%) chemotherapy-naïve and 33 (34%) post-docetaxel patients and associated with worse OS hazard ratio (HR), 3.98; 95% CI 1.74–9.10; P < 0.001 and HR 3.81; 95% CI 2.28–6.37; P < 0.001, respectively, PFS (HR 2.18; 95% CI 1.08–4.39; P = 0.03, and HR 1.95; 95% CI 1.23–3.11; P = 0.01, respectively) and rate of PSA decline≥50% odds ratio (OR), 4.7; 95% CI 1.17–19.17; P = 0.035 and OR, 5.0; 95% CI 1.70–14.91; P = 0.003, respectively. AR mutations 2105T>A (p.L702H) and 2632A>G (p.T878A) were observed in eight (11%) post-docetaxel but no chemotherapy-naïve abiraterone-treated patients and were also associated with worse OS (HR 3.26; 95% CI 1.47–not reached; P = 0.004). There was no interaction between AR and docetaxel status (P = 0.83 for OS, P = 0.99 for PFS). In the PREMIERE trial, 11 patients (12%) with AR gain had worse PSA-PFS (sPFS) (HR 4.33; 95% CI 1.94–9.68; P < 0.001), radiographic-PFS (rPFS) (HR 8.06; 95% CI 3.26–19.93; P < 0.001) and OS (HR 11.08; 95% CI 2.16–56.95; P = 0.004). Plasma AR was an independent predictor of outcome on multivariable analyses in both cohorts.
Plasma AR status assessment using ddPCR identifies CRPC with worse outcome to enzalutamide or abiraterone. Prospective evaluation of treatment decisions based on plasma AR is now required.
NCT02288936 (PREMIERE trial).
El artículo contiene un análisis del Servicio de Atención Emergente a Víctimas indirectas de homicidio, desaparición y feminicidio (SAAEV) desarrollado por el gobierno municipal de Salamanca, ...Guanajuato en México entre el año 2021 y 2024. Este programa es único a nivel municipal por los retos que impone a la administración pública. El objetivo es describir sus principales características, contexto de violencia donde surgió, perfil de los usuarios e identificación de sus principales problemas. La intención es someterlo a un grupo de investigadores expertos de la Red Internacional ALEC para proponer un conjunto de recomendaciones, asesoría y apoyo en la construcción de políticas públicas replicables con impacto social.
L'article contient une analyse du Service de soins émergents pour les victimes indirectes d'homicide, de disparition et de féminicide (SAAEV) développé par la municipalité de Salamanque, Guanajuato au Mexique, entre 2021 et 2024. Ce programme est unique au niveau municipal en raison des défis qu'il impose à l’administration publique. L'objectif est de décrire ses principales caractéristiques, le contexte de violence dans lequel il est né, le profil des utilisateurs et ses principales limites en tant que service public. Il sera évalué par un groupe de chercheurs experts du réseau international ALEC afin qu’un ensemble de recommandations, de conseils et d'accompagnement dans la construction de politiques publiques transférables et à impact social soit mis en place.
O artigo contém uma análise do Serviço de Atendimento Emergente a vítimas indiretas de homicídio, desaparecimento e feminicídio (SAAEV) desenvolvido pelo governo municipal de Salamanca, Guanajuato, no México, entre 2021 e 2024. Este programa é único em nível municipal pelos desafios que impõe à administração pública. O objetivo é descrever suas principais características, o contexto de violência em que surgiu, o perfil do usuário e principais limitações como serviço público. A intenção é submetê-lo a um grupo de investigadores especialistas da rede internacional ALEC para propor um conjunto de recomendações, conselhos e apoio na construção de políticas públicas replicáveis e com impacto social.
This paper contains an analysis of the Emerging Care Service for indirect victims of homicide, disappearance and feminicide (SAAEV) developed by the municipal government of Salamanca, Guanajuato in Mexico between 2021 and 2024. This program is unique of its kind at the municipal level due to the challenges that it imposes on the public administration. The objective is to describe the general characteristics, the context of violence where it arose, the profile of the users and identify the main implementation problems. The intention is to submit it to a team of expert researchers from the ALEC International Network to propose recommendations, advice and support in the construction of replicable public policies with social impact.
PDF
