Natural IVF cycles may be desirable for women with repeated failures by stimulated IVF cycles

Purpose Although many reports support stimulated in vitro fertilization, several patients do not respond to it well. Furthermore, stimulated treatment could be associated with reduced ovarian response. We describe three successful cases involving patients of advanced age from whom dominant follicles were retrieved during the natural cycle. Materials and methods All patients had failed to bear children through stimulated in vitro fertilization. In case 1, a follicle was retrieved after a gonadotropin-releasing hormone agonist was used to induce luteinizing hormone surge. In cases 2 and 3, pregnancy was achieved via completely natural cycles. Results One embryo was transferred every 16 cycles. Ongoing pregnancy—defined as pregnancy progressing beyond gestation week 9—was established in three cycles. The patients successfully delivered and had uneventful neonatal courses. Conclusion Mature oocyte retrieval followed by natural rather than stimulated in vitro fertilization might be a potential treatment for patients of advanced age when stimulated in vitro fertilization has been repeatedly unsuccessful. Capsule We describe three successful pregnancies and deliveries achieved via natural IVF cycles: the patients were older than 37 years with repeated failures by stimulated IVF.     

Epithelial ovarian carcinoma in younger vs older women: is age an independent prognostic factor? The Hellenic Oncology Cooperative Group experience

We retrospectively investigated the outcome of epithelial ovarian cancer (EOC) in women less than 45 years and over 70 years treated with cisplatin-based chemotherapy. We also investigated the impact of various factors on patients' survival. The tumor registry of the Hellenic Cooperative Oncology Group was used to identify women less than 45 years and over 70 years with EOC diagnosed between 1979 and 2004. Survival was calculated by the Kaplan-Meier method, and Cox proportional hazard models were used to determine the independent effect of each variable on survival. Of 1748 EOC patients, 200 were 45 or younger and 282 were over 70 years old. In the univariate analysis, younger age (P < 0.001), better performance status (PS) (P < 0.001), early stage (P < 0.001), 0-2 cm residual disease (P < 0.001), and well or moderate differentiation grade (P= 0.004) were significant prognostic factors for improved survival. In the multivariate analysis, older age (hazard ratio [HR]: 1.88, 95% CI: 1.27-2.77, P= 0.002), advanced stage (HR: 2.87, 95% CI: 1.49-5.52, P= 0.002), PS >1 (HR: 1.91, 95% CI: 1.18-3.08, P= 0.008), and residual disease (HR: 1.46, 95% CI: 1.01-2.13, P= 0.046) were independently associated with inferior survival. With a median follow-up of 45 months (range 0.1-197 months), median survival (118.5 months) of younger patients differed significantly compared to that of older patients (33 months) (P < 0.001). In conclusion, younger women with EOC have significantly improved survival compared to older patients. Age, PS, stage of the disease at diagnosis, and residual disease are important independent predictors for survival.     

Impact of advanced maternal age on neonatal survival of twin small-for-gestational-age subtypes

AIM: We examined the impact of advanced maternal age (>40 years old) on the survival of twin small-for-gestational-age (SGA) infants, that is, infants who were smaller in size than was expected for the baby's sex, genetic heritage, and gestational age. METHODS: The present study was a retrospective cohort study on twin live births in the USA from 1995 to 1998 inclusive. Two categories of SGA babies were defined: discordant (when only one of a twin pair was SGA) and concordant (when both were SGA). Otherwise, the twin pair was appropriate-for-gestational-age (AGA) concordant. RESULTS: 192,195 twin pairs were analyzed. The incidence of SGA discordance and concordance was 11.8% and 3.9%, respectively. The occurrence of both SGA subtypes tended to decrease with increasing maternal age. The unadjusted risk for neonatal mortality increased when both twins were affected (15.8: 22.8 and 56.6 per 1000 among AGA concordant, SGA discordant and SGA concordant twins; P-value for trend < 0.0001). Using maternal-age-specific AGA babies as reference, the adjusted risk for neonatal mortality climbed progressively with advancing maternal age in a dose-dependent pattern, being lowest among teenagers and highest in mothers aged > or =40 years. CONCLUSIONS: SGA discordance and concordance declined with advancing maternal age. In contrast, neonatal mortality of both SGA subtypes worsened with the increase in maternal age compared with that of the age-specific AGA infants. These findings are potentially useful to care providers in counseling older women, a group that is progressively increasing in size and is most susceptible to twining.     

上海市中老年居民口腔健康知识、态度和行为的调查

目的　调查分析上海市中老年居民口腔健康知识、态度和行为 ,为社区牙病防治工作提供必要的信息。方法　采用随机抽样的现况调查方法对上海市闸北区和普陀区 992名中老年人进行问卷调查。结果　口腔健康知识知晓率较低 ,不同文化程度的居民对口腔健康知识的知晓及口腔保健态度和行为有显著差别 (P <0 .0 5 )。结论　亟待进一步完善口腔保健服务体系 ,加大口腔健康知识教育力度 ,并针对不同文化程度的人群采用相应的方式施教。     

多标签决策树分类在数字医学图像分类中的应用

数字医学图像的分类是数字医学图像挖掘的一个重要内容。传统的医学图像分类一般将图片内容明确归入某一类中,而由于医学图像本身的复杂性,这样分类显然不能满足实际需要。多标签数据的普遍存在性和重要性近些年来逐渐得到关注。它承认真实世界对象的多义性,允许样本同时属于多个类别。对多标签决策树分类算法在医学图像分类中的应用进行了设计,并进行了实验验证。     

肝豆状核变性病例回顾及与遗传以外因素的相关性分析

目的：回顾性分析肝豆状核变性（WD ）患者的临床分型、实验室和影像学检查,加强对该病的认识并提高诊断率。方法收集2011年1月至2014年9月该院确诊的WD患者的临床资料,并进行统计学分析。结果不同年龄、民族、性别的WD患者,其初次发病年龄、临床分型、实验室检查均存在着一定的差异,男性患者的发病年龄明显早于女性,神经型WD患者的M RI均存在低密度影改变。结论遗传并不是影响WD的唯一因素,性别、年龄、民族也可能是影响WD患者初次发病年龄及临床症状的因素之一。