[Laser assisted intracytoplasmic sperm injection: a more effective and faster technique of immobilization of spermatozoa than traditional one]. / Impiego del laser per l'immobilizzazione degli spermatozoi: un'alternativa efficace e più rapida alla tecnica tradizionale.

AIM: Intracytoplasmic sperm injection (ICSI) is employed routinely in the assisted reproductive technique, in particular in case of male factor infertility. Recently, some options have been introduced in the micromanipulation system employed in ICSI, improving the performance of this technique. One of these is a no-contact laser, mostly used for the assisted hatching and the blastomere biopsy in preimplantation genetic diagnosis. One of the most important step of the ICSI technique is the sperm immobilization. Normally, this is performed by the operator and needs some time. METHODS: A one-year perspective-comparative study has been carried out and the results obtained with the traditional technique of immobilization of spermatozoa have been compared with those obtained with the laser technique (spermatozoa previously immobilized by no-contact laser). We have evaluated 3 parameters: 1) fertilization rate; 2) cleavage rate and 3) time needed to immobilize sperm. RESULTS: Some interesting findings have been observed: the embryo quality, fertilization rate and cleavage rate seem the same in both groups. The most interesting finding is the drastic reduction of the time needed for microinjection when the laser technique is used. CONCLUSIONS: This technique will reduce the total time needed to perform the ICSI, decreasing the time of exposure of the gametes outside the incubator and reducing the possibility of irreversible damage.

Antituberculosis drug-resistance surveillance as a tool for tuberculosis control programmes: a retrospective study.

The aim of this study was to verify the suitability of antituberculosis (antiTB) drug-resistance surveillance as a tool for tuberculosis (TB) control programmes at local level. A retrospective study reviewing laboratory records and medical records of TB patients referred to Udine Hospital between 1981 and 1995 was analysed. The initial susceptibility pattern for each Mycobacterium tuberculosis isolate was recorded. It was found that between 1981 and 1995, 899 M. tuberculosis strains underwent susceptibility testing for four first-line drugs. Over a period of 15 yrs the annual number of M. tuberculosis strains initially decreased and then stabilized. Overall, 15.3% of the 899 strains showed initial resistance to at least one first-line drug, and 2.8% to two or more first-line drugs. Streptomycin-resistant strains were the most commonly observed (10.8%), with resistance to isoniazid, rifampicin and ethambutal shown to be 6.4, 1.0 and 0.4%, respectively. Multidrug resistant (MDR)-TB was observed in only five cases. An additional four cases eventually developed secondary MDR-TB during the follow-up. The proportion of resistant strains did not vary significantly over time. Recurrent TB disease was significantly associated with resistant strains (odds ratio = 3.59, p < 0.01). Only one patient had a documented human immunodeficiency virus (HIV)-positive serology. All six patients who developed MDR-TB during or after treatment, were suffering either from chronic alcoholism or from a psychotic disorder. In the study it was shown that recurrent tuberculosis cases, tuberculosis patients with behavioural problems (i.e. alcoholism, psychiatric disorder) and patients presenting with primary resistant Mycobacterium tuberculosis strains are at risk of multidrug-resistant tuberculosis and may thus benefit from the directly observed treatment approach, which has been proposed as a mainstay in tuberculosis control programme strategy.