Specific protocols of controlled ovarian stimulation for oocyte cryopreservation in breast cancer patients.

Background: Fertility preservation is an important concern in breast cancer patients. In the present investigation, we set out to create a specific protocol of controlled ovarian stimulation (cos) for oocyte cryopreservation in breast cancer patients. Methods: From November 2014 to December 2016, 109 patients were studied. The patients were assigned to a specific random-start ovarian stimulation protocol for oocyte cryopreservation. The endpoints were the numbers of oocytes retrieved and of mature oocytes cryopreserved, the total number of days of ovarian stimulation, the total dose of gonadotropin administered, and the estradiol level on the day of the trigger. Results: Mean age in this cohort was 31.27 ± 4.23 years. The average duration of cos was 10.0 ± 1.39 days. The mean number of oocytes collected was 11.62 ± 7.96 and the mean number of vitrified oocytes was 9.60 ± 6.87. The mean estradiol concentration on triggering day was 706.30 ± 450.48 pg/mL, and the mean dose of gonadotropins administered was 2610.00 ± 716.51 IU. When comparing outcomes by phase of the cycle in which cos was commenced, we observed no significant differences in the numbers of oocytes collected and vitrified, the length of ovarian stimulation, and the estradiol level on trigger day. The total dose of follicle-stimulating hormone and human menopausal gonadotropin administered was statistically greater in the group starting cos in the luteal phase than in the group starting in the late follicular phase. Conclusions: Our results suggest that using a specific protocol with random-start ovarian stimulation for oocyte cryopreservation in breast cancer patients is effective and could be offered to young women undergoing oncologic treatment.

Inhibin B response to EFORT is associated with the outcome of oocyte retrieval in the subsequent in vitro fertilization cycle.

OBJECTIVE: To examine whether the magnitude of the rise in inhibin B levels after gonadotropin challenge is associated with subsequent response to ovarian stimulation during IVF. DESIGN: Inhibin B serum levels after EFORT (exogenous follicle-stimulating hormone ovarian reserve test). SETTING: Academic clinical practice. PATIENT(S): Serum samples from women who had undergone ovarian reserve screening with FSH in preparation for IVF. Thirteen of these women had a poor response in IVF (canceled cycle for low estradiol and/or no oocytes retrieved), and 19 had a good response (> or =10 oocytes retrieved). INTERVENTION(S): EFORT test. MAIN OUTCOME MEASURE(S): Baseline (day 3) serum E(2) (bE(2)), FSH (bFSH), and inhibin B (bInhB) levels and inhibin B and E(2) levels 24 hours after EFORT (DeltaInhB and DeltaE(2)). RESULT(S): The mean bInhB and DeltaInhB levels were significantly higher in good vs. poor responders. The odds ratio of having a good response for women with a DeltaInhB of 202 pg/mL was 51.8 times (95% CI = 6.1-1,244) the corresponding odds for women with a DeltaInhB of 49 pg/mL. As expected, DeltaE(2) was also significantly higher in good vs. poor responders; however, combination of DeltaE(2) plus DeltaInhB did not improve the odds for predicting IVF response. CONCLUSION(S): Our data suggest that DeltaInhB after EFORT may provide a method for predicting ovarian response to hyperstimulation in a subsequent IVF cycle.

A study of fibrous aerosols in the home environment in Sosnowiec, Poland.

This work constitutes the first report on the concentration of airborne respirable fibers, and their length distribution in different groups of homes in Sosnowiec, Poland. The measurements have been made by using the MIE Laser Fiber Monitor FM-7400. Mean concentration level of the respirable fibers, longer than 5 microns, ranged from 350 m-3 through 910 m-3 up to 1020 m-3 in the homes located in suburban areas, near the busy streets, and in the buildings covered with asbestos-cement sheets, respectively. These results indicate the outdoor asbestos-containing materials as the main sources of airborne fibers inside the Sosnowiec dwellings.

[Advances in the treatment of algodystrophy]. / Postepy w leczeniu algodystrofii.

Current concepts about pathology, diagnosis and treatment of algodystrophy syndromes have been presenting.

Looking for dangerous places: some aspects of medical geography and disease mapping.

Medical geography investigates spatial patterns in the distribution of disease occurrence. The origins of the field can be traced to antiquity, but mapping of disease did not appear until the mid-19th century. Maps can reveal distinctive spatial patterns of certain diseases and may suggest environmental correlates. The geographical distribution of many infectious diseases, such as malaria, with well-known ecology are usually easily understood. The etiology of certain chronic non-infectious diseases which exhibit noticeable geographic variation is often complex. A map of cerebrovascular disease mortality rates in Appalachia is used as an example of an application of modern medical geography.

Exogenous follicle stimulating hormone ovarian reserve test (EFORT): a simple and reliable screening test for detecting 'poor responders' in in-vitro fertilization.

Predicting ovarian response to stimulation constitutes a pivotal task in the organization of a successful in-vitro fertilization (IVF) programme. The purpose of the current study was to determine whether a new ovarian reserve test, the exogenous follicle stimulating hormone ovarian reserve test (EFORT), could improve the predictive value of the classical follicle stimulating hormone (FSH) measurements on cycle day 3 of ovarian stimulation regarding results of IVF. In this prospective study, 52 IVF candidates aged 27-42 years underwent 52 consecutive IVF cycles. These women received 300 IU of purified FSH i.m. on cycle day 3. Blood samples were taken just before the injection to measure plasma FSH and oestradiol; 24 h later, plasma oestradiol concentration was determined. Two menstrual cycles later, ovarian stimulation was performed for IVF using a time-release gonadotrophin-releasing hormone agonist (GnRHa) and human menopausal gonadotrophin (HMG). For the interpretation of the EFORT results, we considered the post-FSH plasma oestradiol increment (delta E2) and the baseline plasma FSH values (bFSH). The results of these two parameters were compared with the subsequent quality of the ovarian response to stimulation for IVF and the pregnancy outcome. Our results indicated a statistically significant improvement of the predictive value of the bFSH on the ovarian stimulation outcome when the EFORT parameters (bFSH and delta E2) were analysed synergistically.(ABSTRACT TRUNCATED AT 250 WORDS)

[Value of cryopreservation of human embryos during the blastocyst stage]. / Intérêt de la congélation des embryons humains au stade de blastocyste.

The recent development of co-culture technique has permitted to cryopreserve human embryos at the blastocyst stage. The aim of the present study was to compare pregnancy rates after transfers of embryos frozen at an early embryo stage (2-8 cell stage, group A; n = 175) with others frozen at blastocyst stage (group B; n = 98). Our results demonstrated that the frozen/thawed blastocyst survival is approximately 100%. In comparison the early embryos survival rate was 59% (P < 0.05). Moreover, pregnancy rates/embryo transfer in group A (16.4%) were significantly improved by comparison to those observed with early embryos (6.2%) (P < 0.05). In conclusion, our results demonstrate that embryo frozen/thawed at the blastocyst stage can be useful for improving pregnancy rates after cryopreservation.

[Functional treatment of crush fracture of the distal femur--case histories]. / Leczenie czynnosciowe zmiazdzeniowych zlaman dalszych nasad kosci udowych--przypadki kazuistyczne.

Functional treatment of crush fractures of distal femur in 2 patients is described. Quadriceps-plasty has been performed in both cases due to the muscle adhesion to bony fragments. Osteosynthesis was contraindicated by the nature of the fracture. Functional treatment resulted in good function and efficient gait in both patients.

Leukemia mortality rates along the Ohio River compared with the rest of Ohio.

A sample of 18 Ohio municipalities indicates statistically significant difference in leukemia mortality rates between communities on the Ohio River and communities not located along the river. Rates are higher along the Ohio River in comparison to the state rate. Ohio River community rates are also generally higher than those in communities located away from the river. Some possible reasons are proposed.

Differences in cancer mortality rates in Ohio communities with respect to uraniferous geology.

Populations in areas of uraniferous geology may be at risk from radon emissions. Twenty-eight municipalities were examined as to their location with respect to uraniferous geology. Communities with possible radon risk had higher rates for all cancers and cancer of the respiratory system, but differences were not statistically significant. Some possible reasons for the results are discussed.

Cerebrovascular disease mortality rates and water hardness in North Dakota.

Geographic clustering of high and low cerebrovascular disease mortality rates is evident within North Dakota. It was hypothesized that this distribution might be related to geographic variations in drinking water hardness. Correlation analysis indicated that associations between cerebrovascular disease death rates and several drinking water constituents were weak. Although some weak relationships exist, it does not appear that the water factor can adequately account for the spatial pattern of cerebrovascular disease in North Dakota.