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31.
Antiphospholipid antibodies and the outcome of pregnancy after the first in-vitro fertilization and embryo transfer cycle 总被引:1,自引:1,他引:1
Balasch J; Creus M; Fabregues F; Civico S; Reverter JC; Carmona F; Tassies D; Vanrell JA 《Human reproduction (Oxford, England)》1998,13(5):1180-1183
Increased antiphospholipid antibody prevalence has been demonstrated by a
number of recent studies in in-vitro fertilization (IVF) patients but the
potential effects of antiphospholipid antibodies on the different
components of the reproductive process and the consideration of whether to
test IVF patients for antiphospholipid antibodies are controversial. The
present study was undertaken to investigate the possible association
between the presence of circulating antiphospholipid antibodies (namely the
lupus anticoagulant and anticardiolipin antibodies), among a series of 21
consecutive IVF patients having a clinical spontaneous abortion after their
first embryo transfer. As a control group (n=42), the nearest IVF cycle
resulting in an ongoing pregnancy before and after each miscarried IVF
cycle (i.e. the closest cycles in temporal relationship to the index cycle)
was used. One patient (4.8%) in the study group and two women (4.8%) among
controls were seropositive for antiphospholipid antibodies. These low and
similar seropositivity rates found in the two groups studied lead us to
conclude that antiphospholipid antibodies testing in IVF patients should be
considered only in those women having repeated failures of
implantation/clinical abortion after embryo transfer but not in an
infertile general population reaching an IVF programme.
相似文献
32.
The effectiveness of a treatment protocol for male lower urinary tract symptoms in general practice: a practical randomised controlled trial 下载免费PDF全文
Roelf JC Norg Kees van de Beek Piet JM Portegijs CP Onno van Schayck J Andr Knottnerus 《The British journal of general practice》2006,56(533):938-944
BACKGROUND: Randomised controlled trials have shown the efficacy of several treatment modalities for lower urinary tract symptoms (LUTS) in selected populations. The effectiveness in daily practice has hardly been investigated, especially in primary care and is dependent on choices between all possible treatment options and best investigated in a comprehensive study, including all treatment modalities (watchful waiting, alpha-blockers, 5-alpha-reductase inhibitors, and surgery). AIM: Assessment of the effectiveness of a comprehensive treatment protocol for LUTS in primary care. DESIGN OF STUDY: Randomised controlled trial. SETTING: Fourteen general practices in the Netherlands. METHOD: Intervention: treatment protocol based on a formalised expert opinion. Control condition: usual care. Study population: 208 subjects with moderate to severe LUTS (IPSS > or =8, median = 13). OUTCOME MEASURES: symptom severity (IPSS [International Prostate Symptom Score]), bother score (Dan-PSS [Danish Prostate Symptom Score]), and maximum urinary flow (Q(max)); incidence of acute urinary retention and urinary tract infections. RESULTS: In the intervention group markedly more subjects used an alpha-blocker at end of follow-up than in the usual care group (24% versus 6%). No significant differences were found between intervention and control group in IPSS, Q(max) or Dan-PSS. CONCLUSION: alpha-blockers and watchful waiting are the most frequent treatment modalities for LUTS in primary care. Our study showed no evidence that a protocol using well-defined indications for all possible treatment modalities based on a formalised expert opinion procedure has added value. Based on our results, we cannot recommend a broadening of the indication for alpha-blockers, which, however, seems to be the current trend. 相似文献
33.
Clarke GN; Bourne H; Hill P; Johnston WI; Speirs A; McBain JC; Baker HW 《Human reproduction (Oxford, England)》1997,12(4):722-726
Donor insemination (DI) using cryopreserved semen commenced at The Royal
Women's Hospital in 1976. Over the next 15 years we performed 5953
treatment cycles to achieve 816 pregnancies (13.7% per cycle) and 706 live
births. In-vitro fertilization (IVF) using donor spermatozoa commenced in
1986. Over the next 5 years we performed 303 treatment cycles for 185
couples. Including subsequent transfer of cryopreserved embryos, a total of
33% of couples achieved a successful pregnancy by IVF. Statistical analysis
indicated that, for DI pregnancies, the most important semen variable was
the percentage post-thaw motility, whilst for normal fertilization in IVF
it was the pre-freeze motility. These results may be explained by the
compensatory effects of post-thaw processing of spermatozoa for IVF, but
not for DI in our clinic.
相似文献
34.
35.
JC Bos R Stoeckart AIJ Klooswijk B van Linge R Bahadoer 《Surgical and radiologic anatomy : SRA》1994,16(3):253-258
Summary In view of the increasing popularity of the direct lateral approach to the hip joint for hemi- or total hip arthroplasty, the location of the superior gluteal nerve (SGN) was studied. This nerve is in danger when using a transgluteal incision. In 20 embalmed specimens the relation of the SGN to the tip of the greater trochanter (TT) was studied as well as the relation to the iliac crest. For this purpose macroscopy, microscopy and CT were used. In 13 hips a so-called most inferior branch was found at an average of 1 cm distal to the inferior branch, the main trunk of the nerve. There was substantial variation in the course of both the inferior and the most inferior branch of the SGN. In order to prevent nerve damage, proximal extension of the transgluteal incision should be limited to 3 cm cranial to TT. Furthermore the incision has to be confined to the distal one third of the distance TT-iliac crest. In tall people extra care should be taken.
Anatomie chirurgicale du nerf glutéal supérieur et bases anatomo-radiologiques de l'abord latéral direct de la hanche
Résumé Les recours de plus en plus fréquent à la voie latérale directe de la hanche pour les prothèses totales ou cervico céphaliques nous a conduit à étudier la localisation du nerf glutéal supérieur (SGN) qui est exposé lors de l'incision transglutéale. Les rapports du SGN avec le sommet du grand trochanter (TT) et avec la crête iliaque ont été étudiés sur 20 cadavres embaumés. Nous avons eu recours à l'étude macroscopique, microscopique ainsi qu'au scanner. Dans 13 cas nous avons mis en évidence une branche très inférieure, donc plus distale, située 1 cm en moyenne en dessous de la branche inférieure habituelle de bifurcation du tronc principal. Il existait des variations importantes dans les trajets de ces deux branches inférieures. Afin de prévenir une lésion chirurgicale du nerf, l'incision transglutéale ne doit pas aller au delà de 3 cm du sommet du grand trochanter, de plus l'incision doit être confinée en dessous du tiers distal de la ligne joignant le grand trochanter à la crête iliaque.相似文献
36.
Jacob K. Anninga Renato A. Valdés Olmos Jan de Kraker Harm van Tinteren Cornelis A. Hoefnagel Eric A. van Royen 《European journal of nuclear medicine and molecular imaging》1994,21(7):658-662
Quantitative 99mTc-dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy was used to asses ifosfamide-induced changes in renal function in 11 children who received chemotherapy for various malignancies. Serial measurements of absolute 99mTc-DMSA renal uptake, calculated on conjugated views, were performed during and after chemotherapy. Data of 37 studies obtained before and at different cumulative dose levels of ifosfamide were analysed in relation to clinical and biochemical parameters. A highly significant relationship between 99mTc-DMSA uptake and cumulative ifosfamide dose was found (P<0.001). The most frequently observed abnormal pattern on scintigraphic images was decreased kidney uptake together with increased accumulation in bladder. 99mTc-DMSA uptake was more consistent than 2-microglobulin values in urine and more sensitive than quantitative hyperaminoaciduria and tubular resorption of phosphate for the detection of ifosfamide-induced tubular dysfunction. 99mTc-DMSA uptake was decreased in both patients with and patients without clinical toxicity. Persistently reduced 99mTc-DMSA uptake was observed in four patients during follow-up; in one of them, who was asymptomatic after ifosfamide therapy, sudden onset of Fanconi syndrome was observed when he was retreated with carboplatin 1 year later. It is concluded that 99mTc-DMSA renal scintigraphy is a suitable method to assess progressive ifosfamide-induced tubular injury whereas scintigraphic imaging is helpful for interpreting renal uptake changes. The test is able to detect subclinical injury and may potentially predict high risk at retreatment. 相似文献
37.
G. Olmos R. Alemany J. A. García-Sevilla 《Naunyn-Schmiedeberg's archives of pharmacology》1996,354(6):709-716
I2-imidazoline receptors labelled with [3H]-idazoxan in the rabbit and rat brains displayed high and low affinity, respectively, for the guanidide amiloride; reinforcing the previous definition of I2A-imidazoline receptors expressed in the rabbit brain and Its-imidazoline receptors expressed in the rat brain. Other drugs tested displayed biphasic curves in competition experiments, indicating the existence of high and low affinity sites for both subtypes of I2-imidazoline receptors. Among the drugs studied, bromoxidine, moxonidine, (+)- and (-)-medetomidine and clorgyline were more potent on the high and/or low affinity sites of 12B- than on their corresponding of I2A-imida-zoline receptors (K
iH
ratios 20 to 65). No correlation was found for the potencies of the drugs tested at the low affinity sites of both I2-imidazoline receptor subtypes. Preincubation (30 min at 25°°C) with 10-6 M clorgyline reduced by 60% the B
max of [3H]-idazoxan binding to I2 B-imidazoline receptors in the rat brain, but it did not affect the binding parameters of the radioligand saturation curves to I2A-imidazoline receptors in the rabbit brain. These results indicated that I2A- and I2B-imidazoline receptor subtypes differ in the pharmacological profiles of their high and low affinity sites and in the ability to irreversibly bind clorgyline. In rat cortical membranes western blot detection of immunoreactive imidazoline receptor proteins revealed a double band of 29/30 kDa and two less intense bands of 45 and 66 kDa. In rabbit cortical membranes the antibody used detected proteins of 30, 57 and 66 kDa. It is suggested that different imidazoline receptor proteins (45 vs 57 kDa) may account for the different pharmacological profiles of I2-imidazoline receptor subtypes. 相似文献
38.
P Laugier R Kuffer L Olmos N Hunziker M Rougier G Fiore-Donno 《Annales de dermatologie et de vénéréologie》1979,106(5):453-463
These 8 cases of multiple hamartoma syndrome are the first reported in Switzerland. Two men aged respectively of 65 and 28 years presented a cobblestone appearance of the gingiva and of the tongue ("pebbly tongue"), which suggested Cowden disease. This diagnosis was confirmed by the discovery of numberous skin lesions, a thyroid goiter, gastrointestinal polyposis, and a mild skelettal dysmorphosis. The older patient had a grade one carcinoma of the bladder; his son and his daughter presented the syndrome, which was also discovered in the family of the second patient (his father, his brother, his sister and one of her daughters). The ultrastructural study of two skin biopsies demonstrated anomalies of the fibroblasts and collagen fibers. 相似文献
39.
Marina Kartachova Rick L M Haas Renato A Valdés Olmos Frank J P Hoebers Nico van Zandwijk Marcel Verheij 《Radiotherapy and oncology》2004,72(3):333-339
BACKGROUND AND PURPOSE: Anticancer therapy induces apoptosis in a dose- and time-dependent fashion. (99m)Tc-Hynic-rh-Annexin V scintigraphy (TAVS) enables non-invasive in vivo imaging of treatment-induced apoptosis. We identified the visual patterns of (99m)Tc-Hynic-rh-Annexin V tumour uptake and related these to treatment response. PATIENTS AND METHODS: Thirty-three patients with malignant lymphoma (n=26), leukaemia (n=1) NSCLC (n=5), H&NSCC (n=1), scheduled for radiotherapy (n=27), platinum-based chemotherapy (n=5) or concurrent chemoradiation (n=1), underwent TAVS before and early after the start of treatment. Planar and SPECT images were visually examined to assess changes in tumour (99m)Tc-Hynic-rh-Annexin V uptake. Twenty-nine patients were eligible for further analysis. Annexin V uptake before (U(baseline)) and early after (U(post)) the start of treatment was graded using a four-step scale: 0, absent; 1, weak; 2, moderate and 3, intense. The difference between these values (Delta U) was calculated and correlated to tumour response after therapy (Spearman rank correlation test). RESULTS: Weak to moderate U(baseline) was detected in 13/15 patients with a complete response and U(post) was markedly increased in all these cases (Delta U range 1-3). Partial response (n=7) was associated with weak to moderate U(baseline) and a moderately increased U(post) (Delta U range 1-2). In patients with stable disease (n=5), U(baseline) was predominantly weak, without considerable changes in uptake after the start of treatment (Delta U range 0-1). Finally, in case of progressive disease (n=2), either no tumour uptake or a decrease in U(post) was detected (Delta U=-1). A statistically significant correlation was found between changes in (99m)Tc-Hynic-rh-Annexin V tumour uptake and clinical response (correlation coefficient=0.62; P<0.001). CONCLUSIONS: Complete or partial tumour response was associated with a marked increase of (99m)Tc Hynic-rh-Annexin V accumulation early during treatment compared to baseline values. In case of stable or progressive disease, pretreatment scans demonstrated predominantly low (99m)Tc Hynic-rh-Annexin V tumour uptake and no significant increase early after treatment. These results indicate that TAVS might be useful as a predictive test for treatment response. 相似文献
40.
JC VANCE DC CHANT DI TUDEHOPE PH GRAY AJ HAYES 《Journal of paediatrics and child health》1997,33(6):504-508
Objectives: To describe the physical growth patterns of infants born to narcotic dependent mothers (INDM) over a 12 months period and, if possible, to relate the growth to drug taking patterns during pregnancy.
Methodology: The growth of a cohort of 43 INDM was measured during the first 12 months of life. Weight and length measurements were compared with percentile charts and converted to Z scores. Questionnaire data about drug taking practices, demographic variables and the neonatal period (including withdrawal scores) were obtained.
Results: Twenty-four (55.8%) of INDM had evidence of neonatal drug withdrawal requiring treatment with phenobarbitone. At birth, Z scores for weight and length indicated relative intrauterine growth retardation. By 12 months, there had been some catch up growth, but Z scores for weight and length were still below zero. Persistent weight retardation at 12 months was correlated with methadone dosage during pregnancy, but not the need for phenobarbitone therapy.
Conclusions: The growth patterns of INDM in the first 12 months of life indicated that at birth there was evidence of intrauterine growth retardation, but by 12 months the growth was little different from the rest of the community. There appears to be some influence of narcotic agents taken while pregnant on subsequent growth of INDM. 相似文献
Methodology: The growth of a cohort of 43 INDM was measured during the first 12 months of life. Weight and length measurements were compared with percentile charts and converted to Z scores. Questionnaire data about drug taking practices, demographic variables and the neonatal period (including withdrawal scores) were obtained.
Results: Twenty-four (55.8%) of INDM had evidence of neonatal drug withdrawal requiring treatment with phenobarbitone. At birth, Z scores for weight and length indicated relative intrauterine growth retardation. By 12 months, there had been some catch up growth, but Z scores for weight and length were still below zero. Persistent weight retardation at 12 months was correlated with methadone dosage during pregnancy, but not the need for phenobarbitone therapy.
Conclusions: The growth patterns of INDM in the first 12 months of life indicated that at birth there was evidence of intrauterine growth retardation, but by 12 months the growth was little different from the rest of the community. There appears to be some influence of narcotic agents taken while pregnant on subsequent growth of INDM. 相似文献