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81.
Nataliya V. Dolgushina Anastasiia G. Syrkasheva Nataliya P. Makarova Eugenia V. Kovalskaya Elena A. Kalinina Gennady T. Sukhikh 《Gynecological endocrinology》2015,31(10):61-64
AbstractPurpose: To evaluate the aneuploidy rates of 13, 18, and 21 and the X and Y chromosomes in embryos from patients with morphologically normal oocytes and different oocyte dysmorphisms.Methods: This prospective cohort study included 84 patients treated with in vitro fertilization (IVF) at a single academic center. The patients were divided into the following three groups: group 1 – women with cytoplasmic dysmorphisms (n?=?28), group 2 – women with extracytoplasmic dysmorphisms (n?=?28), and group 3 – women with morphologically normal oocytes (n?=?28). One blastomere from each embryo was analyzed for aneuploidies of chromosomes 13, 18, 21, X, and Y.Results: The highest prevalence of aneuploid embryos was observed in the group 1 (68.4%) followed by the group 2 (38.9%) and the group 3 (31.3%) (р?<?0.0001). The adjusted OR for receiving an aneuploid embryo in the case of cytoplasmic dysmorphism was 3.6 (95% CI?=?1.8; 7.2), in the case of extracytoplasmic dysmorphisms – 1.3 (95% CI?=?0.7; 2.1).Conclusions: Women with morphological oocyte abnormalities are at risk for developing aneuploid embryos during IVF cycles. We recommend that woman with cytoplasmic oocyte dysmorphisms receive additional genetic counseling to define the indications for the genetic screening of embryos. 相似文献
82.
Eugenia Sánchez Rodríguez Raquel Ríos León Francisco Mesonero Gismero Agustín Albillos Antonio Lopez-Sanroman 《Gastroenterologia y hepatologia》2018,41(10):629-635
Introduction
Thiopurine therapy can be optimised by determining the concentration of the drug's metabolites.Patients and methods
Retrospective analysis on a prospective database of 31 patients with inflammatory bowel disease who failed therapy with thiopurines. Thiopurine metabolites (6-thioguanine, 6-TGN and 6-methylmercaptopurine, 6-MMP) were measured by high-performance liquid chromatography (Laboratorios Cerba, Barcelona) and treatment was duly adjusted in accordance with the results. Clinical response was reassessed after six months.Result
Despite the appropriate theoretical dose of thiopurines being administered, the dose was insufficient in 45.6% of patients (nonadherence to treatment suspected in 6.45%) and 16.2% received an excessive dose or the drug was metabolised by other metabolic pathways. After treatment was optimised based on metabolite levels, only 25.8% (8/31) were prescribed a biological agent, while 74.2% of cases (23/31) were managed through dose optimisation alone.Discussion
Monitoring thiopurine metabolite levels may help clinicians to assess non-responsive patients before adding or switching to another drug (generally a biological agent), thereby avoiding any additional costs or potential toxicity. This strategy may also help to identify patients receiving an insufficient dose and those with an alternative metabolic pathway, who could be candidates for low-dose AZA with allopurinol, as well as patients who are suspected of being non-adherent. In three out of four patients, switching to a biological agent can be avoided. 相似文献83.
Percutaneous coronary interventions in diabetic patients: is complete revascularization important? 总被引:1,自引:0,他引:1
Nikolsky E Gruberg L Patil CV Roguin A Kapeliovich M Petcherski S Boulos M Grenadier E Amikam S Linn S Markiewicz W Beyar R 《The Journal of invasive cardiology》2004,16(3):102-106
BACKGROUND: The long-term prognosis of diabetic patients with multivessel coronary artery disease (CAD) treated by surgical or percutaneous coronary revascularization is significantly worse as compared to non-diabetics. Lower rates of complete revascularization may be one factor that influences the poor long-term outcome in the diabetic population. Our study assessed the impact of complete revascularization on the long-term prognosis in diabetic patients with CAD treated by percutaneous coronary intervention (PCI). The study included 658 consecutive diabetic patients (mean age, 60.9+/-10.1 years) who underwent PCI. Multivessel disease was present in 352 patients (53.5%). Revascularization was complete in 94 (26.7%) and incomplete in 258 (73.3%) patients with multivessel disease. Reasons for incomplete revascularization included angioplasty of only the culprit lesion (43.4%); small vessel size (22.8%); moderate lesion, defined as diameter stenosis 50-69% (18.6%); chronic total occlusion of the non-intervened vessel (6.6%); and others (8.5%). Overall survival rate at 5 years was 87.4%. Patients who underwent complete revascularization had a 94.5% survival rate, compared to 83.0% for those with incomplete revascularization (p<0.001). Similarly, the rates of myocardial infarction-free survival were significantly higher in patients with complete versus incomplete revascularization (92.9% versus 79.9%, respectively). Incomplete revascularization was the most powerful independent predictor of mortality at follow-up (relative risk 95% confidence interval, 1.54-7.69; p=0.003). Our data suggest that complete myocardial revascularization may improve the long-term prognosis after PCI of diabetic patients with multivessel CAD. 相似文献
84.
Nikolsky E Halabi M Roguin A Zdorovyak A Gruberg L Hir J Grenadier E Boulos M Markiewicz W Linn S Beyar R 《American heart journal》2002,143(6):1017-1026
Background Percutaneous coronary interventions (PCIs) in patients with multivessel coronary artery disease (CAD) may be staged or performed in a single session. No data exist about the relative safety and efficacy of these 2 strategies. Our aim was to compare short-term and long-term outcomes of patients with multivessel CAD who underwent PCI in 1 versus 2 sessions. Methods and Results The study included 264 consecutive patients who underwent treatment in our center during 1997 and 1998. PCI was conducted in a single session in 129 patients and was staged in 135 patients. The mean interval between the sessions in the staged group was 45.6 ± 22.3 days. The rates of major adverse cardiac events (MACEs) during in-hospital stay did not differ significantly between the staged (combined for both stages) and nonstaged groups (2.2% vs 4.6%; P = .28). A trend for lower event rates at 30-day (2.9% vs 6.9%; P = .13) and 1-year follow-up (26.1 vs 35.9; P = .08) favored the staged arm. Diameter stenosis ≥50% was found in 17% of patients in the staged group in the second session and was successfully retreated in most of them. No MACE occurred between the sessions. Multivariate analysis identified staging of the procedure as a single independent predictor of MACE at 1-year follow-up (P = .05). Conclusion Our results suggest that a practical staging strategy within 4 to 8 weeks is safe and allows for identification and treatment of potential excessive proliferative response in the previously intervened lesions during the second procedure. (Am Heart J 2002;143:1017-26.) 相似文献
85.
Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables 总被引:9,自引:0,他引:9
Dangas G Iakovou I Nikolsky E Aymong ED Mintz GS Kipshidze NN Lansky AJ Moussa I Stone GW Moses JW Leon MB Mehran R 《The American journal of cardiology》2005,95(1):13-19
We previously found that contrast-induced nephropathy (CIN) complicating percutaneous coronary intervention adversely affects patients with chronic kidney disease (CKD). Therefore, we further investigated whether the predictors and outcome of CIN after percutaneous coronary intervention differ among patients with versus without CKD. Among 7,230 consecutive patients, CIN (>or=25% or >or=0.5 mg/dl increase in preprocedure serum creatinine 48 hours after the procedure) developed in 381 of 1,980 patients (19.2%) with baseline CKD (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m(2)) and in 688 of 5,250 patients (13.1%) without CKD. Decreased eGFRs, periprocedural hypotension, higher contrast media volumes, lower baseline hematocrit, diabetes, pulmonary edema at presentation, intra-aortic balloon pump use, and ejection fraction <40% were the most significant predictors of CIN in patients with CKD. Apart from intra-aortic balloon pump use, predictors of CIN in patients without CKD were the same as mentioned, plus older age and type of contrast media. Regardless of baseline renal function, CIN correlated with longer in-hospital stay and higher rates of in-hospital complications and 1-year mortality compared with patients without CIN. By multivariate analysis, CIN was 1 of the most powerful predictors of 1-year mortality in patients with preexisting CKD (odds ratio 2.37, 95% confidence interval 1.63 to 3.44) or preserved eGFR (odds ratio 1.78; 95% confidence interval 1.22 to 2.60). Thus, regardless of the presence of CKD, baseline characteristics and periprocedural hemodynamic parameters predict CIN, and this complication is associated with worse in-hospital and 1-year outcomes. 相似文献
86.
87.
88.
Pituitary - Prolactin (PRL) has direct and indirect effects on bone metabolism. Experimental studies showed that in the presence of high PRL levels bone resorption was increased as well as bone... 相似文献
89.
Gian?Domenico?PinnaEmail author Elena?Robbi Fabio?Pizza Anna?Eugenia?Taurino Caterina?Pronzato Maria?Teresa?La?Rovere Roberto?Maestri 《Sleep & breathing》2014,18(3):475-482