Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 93
Filtrar
1.
J Zoo Wildl Med ; 54(4): 681-691, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38251991

RESUMO

The objective of this retrospective study is to summarize causes of disease and mortality in maned wolves (Chrysocyon brachyurus) in the North American Species Survival Plan Program (SSP) population. This information will inform and enhance animal health, husbandry, and conservation efforts. Pathology reports were requested from all zoological institutions housing maned wolves between 1930 and 2021. Data were reviewed and cause of death (COD) and reported diseases were summarized and compared by age group, organ system and disease process. One hundred and seventy-one wolves, 82 females and 89 males, met the inclusion criteria. The majority were geriatric (>11 yr; n = 96) or adult (2-11 yr; n = 67). Noninfectious diseases were the most common COD by process (n = 94; 54.9%). For COD by organ system, diseases of the digestive (n = 41) and urinary (n = 34) systems were most common. Neoplasia was the most common noninfectious COD and was the primary COD in 37 wolves (21.6% overall; 39.4% of noninfectious diseases). A total of 145 benign (n = 72) and malignant (n = 73) neoplasms were diagnosed in 44 individuals. Dysgerminoma was the most commonly reported tumor (n = 18), and was the most common neoplastic COD (n = 8). Cystinuria or urolithiasis (n = 71) and gastritis, enteritis, enterocolitis, or colitis (n = 50) (overall and grouped in each system due to presumed common underlying cause) were also common but were more often reported as comorbidities than as COD (n = 16 and n = 11, respectively). Infectious COD were reported in 17 wolves and included babesiosis (n = 4), acanthocephalans (n = 2), and one viral infection. Infections with a variety of bacteria in different organ systems were a COD in eight wolves.


Assuntos
Canidae , Doenças Inflamatórias Intestinais , Neoplasias , Doenças não Transmissíveis , Urolitíase , Lobos , Humanos , Animais , Feminino , Masculino , Estudos Retrospectivos , Doenças não Transmissíveis/veterinária , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/veterinária , Urolitíase/veterinária , Neoplasias/veterinária , América do Norte
2.
Hum Reprod ; 38(12): 2391-2399, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-37877423

RESUMO

STUDY QUESTION: Does the transfer of single low-grade blastocysts result in acceptable reproductive and perinatal outcomes compared to the transfer of single good-grade blastocysts? SUMMARY ANSWER: The transfer of single low-grade blastocysts resulted in a reduced live birth rate of around 30% (14% for very low-grade blastocysts) compared to 44% for single good-grade blastocysts, but does not lead to more adverse perinatal outcomes. WHAT IS KNOWN ALREADY: It is known that low-grade blastocysts can result in live births. However, the current studies are limited by relatively small sample sizes and single-centre designs. Furthermore, evidence on perinatal outcomes after transferring low-grade blastocysts is limited. STUDY DESIGN, SIZE, DURATION: We conducted a multi-centre, multi-national retrospective cohort study of 10 018 women undergoing 10 964 single blastocyst transfer cycles between 2009 and 2020 from 14 clinics across Australia, China, and New Zealand. PARTICIPANTS/MATERIALS, SETTING, METHODS: Blastocysts were graded individually based on assessment of the morphology and development of the inner cell mass (ICM) and trophectoderm (TE), and were grouped into three quality categories: good- (AB, AB, or BA), moderate- (BB), and low-grade (grade C for ICM or TE) blastocysts. CC blastocysts were individually grouped as very low-grade blastocysts. Logistic regression with generalized estimating equation was used to analyse the association between blastocyst quality and live birth as well as other reproductive outcomes. Binomial, multinomial logistic, or linear regression was used to investigate the association between blastocyst quality and perinatal outcomes. Odds ratio (OR), adjusted OR (aOR), adjusted regression coefficient, and their 95% CIs are presented. Statistical significance was set at P < 0.05. MAIN RESULTS AND THE ROLE OF CHANCE: There were 4386 good-grade blastocysts, 3735 moderate-grade blastocysts, and 2843 low-grade blastocysts were included in the analysis, for which the live birth rates were 44.4%, 38.6%, and 30.2%, respectively. Compared to good-grade blastocysts, the live birth rate of low-grade blastocysts was significantly lower (aOR of 0.48 (0.41-0.55)). Very low-grade blastocysts were associated with an even lower live birth rate (aOR 0.30 (0.18-0.52)) and their absolute live birth rate was 13.7%. There were 4132 singleton live births included in the analysis of perinatal outcomes. Compared with good-grade blastocysts, low-grade blastocysts had comparable preterm birth rates (<37 weeks, aOR 1.00 (0.65-1.54)), birthweight Z-scores (adjusted regression coefficient 0.02 (0.09-0.14)), and rates of very low birth weight (<1500 g, aOR 0.84 (0.22-3.25)), low birth weight (1500-2500 g, aOR 0.96 (0.56-1.65)), high birth weight (>4500 g, aOR 0.93 (0.37-2.32)), small for gestational age (aOR 1.63 (0.91-2.93)), and large for gestational age (aOR 1.28 (0.97-1.70)). LIMITATIONS, REASONS FOR CAUTION: Due to the nature of the retrospective design, residual confounding could not be excluded. In addition, the number of events for some perinatal outcomes was small. Between-operator and between-laboratory variations in blastocyst assessment were difficult to control. WIDER IMPLICATIONS OF THE FINDINGS: Patients undergoing IVF should be informed that low-grade blastocysts result in a lower live birth rate, however they do not increase the risk of adverse perinatal outcomes. Further research should focus on the criteria for embryos that should not be transferred and on the follow-up of long-term outcomes of offspring. STUDY FUNDING/COMPETING INTEREST(S): H.Z. is supported by a Monash Research Scholarship. B.W.J.M. is supported by a NHMRC Investigator grant (GNT1176437). R.W. is supported by an NHMRC Emerging Leadership Investigator grant (2009767). B.W.J.M. reports consultancy, travel support, and research funding from Merck. The other authors do not have competing interests to disclose. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Nascimento Prematuro , Gravidez , Humanos , Recém-Nascido , Feminino , Estudos Retrospectivos , Transferência Embrionária/métodos , Nascido Vivo , Peso ao Nascer , Blastocisto
3.
J Immunol ; 211(6): 994-1005, 2023 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-37556156

RESUMO

Long-lived T-dependent B cell responses fail to develop during persistent infection of mice with Borrelia burgdorferi, the causative agent of Lyme disease, raising questions about the induction and/or functionality of anti-B. burgdorferi adaptive immune responses. Yet, a lack of reagents has limited investigations into B. burgdorferi-specific T and B cells. We attempted two approaches to track B. burgdorferi-induced CD4 T cells. First, a B. burgdorferi mutant was generated with an influenza hemagglutinin (HA) peptide, HA111-119, inserted into the B. burgdorferi arthritis-related protein (Arp) locus. Although this B. burgdorferi arp::HA strain remained infectious, peptide-specific TCR transgenic CD4 T cells in vitro, or adoptively transferred into B. burgdorferi arp::HA-infected BALB/c mice, did not clonally expand above those of recipients infected with the parental B. burgdorferi strain or a B. burgdorferi mutant containing an irrelevant peptide. Some expansion, however, occurred in B. burgdorferi arp::HA-infected BALB/c SCID mice. Second, a (to our knowledge) newly identified I-Ab-restricted CD4 T cell epitope, Arp152-166, was used to generate Arp MHC class II tetramers. Flow cytometry showed small numbers of Arp-specific CD4 T cells emerging in mice infected with B. burgdorferi but not with Arp-deficient Borrelia afzelii. Although up to 30% of Arp-specific CD4 T cells were ICOS+PD-1+CXCR5+BCL6+ T follicular helper cells, their numbers declined after day 12, before germinal centers (GCs) are prominent. Although some Arp-specific B cells, identified using fluorochrome-labeled rArp proteins, had the phenotype of GC B cells, their frequencies did not correlate with anti-Arp serum IgG. The data suggest a failure not in the induction, but in the maintenance of GC T follicular helper and/or B cells to B. burgdorferi.


Assuntos
Borrelia burgdorferi , Doença de Lyme , Camundongos , Animais , Linfócitos T CD4-Positivos , Camundongos SCID , Linfócitos B
4.
J Zoo Wildl Med ; 54(2): 379-386, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37428703

RESUMO

Air sac trematodes (Digenea: Cyclocoelidae) were detected in 23 avian species from eight aviaries in the United States. Most of the infected host species were passeriform birds, but a few species in other orders also were infected. Four species of adult flukes were encountered: Circumvitellatrema momota, Morishitium sp., Psophiatrema greineri, and Szidatitrema yamagutii. Findings from retrospective review of medical records, necropsy records, and author observations are presented. Potential terrestrial snail intermediate hosts were collected from three indoor aviaries. A high prevalence (47%) of larval trematode infections was demonstrated in one species of nonnative snail (Prosopeas achatinacea); one larva was isolated and matched to the adult species (C. momota) from birds using PCR. Problems with introducing potentially infected wild-caught birds into aviaries, and exchanging captive individuals between aviaries where they potentially may carry infections, are discussed.


Assuntos
Trematódeos , Infecções por Trematódeos , Animais , Estados Unidos/epidemiologia , Sacos Aéreos , Infecções por Trematódeos/epidemiologia , Infecções por Trematódeos/veterinária , Aves , Larva , Caramujos
5.
J Med Primatol ; 52(4): 276-278, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37337367

RESUMO

A 41-year-old male vasectomized, zoo-housed chimpanzee (Pan troglodytes) presented with progressive visual deficits due to bilateral cataract formation. Phacoemulsification and lenticular implant were performed by a veterinary and human board-certified ophthalmologist team in a field setting. Post-operative healing occurred without complication, and the patient returned to the troop with improved vision.


Assuntos
Animais de Zoológico , Extração de Catarata , Pan troglodytes , Masculino , Animais , Pan troglodytes/cirurgia , Animais de Zoológico/cirurgia , Catarata/veterinária , Extração de Catarata/métodos , Extração de Catarata/veterinária , Resultado do Tratamento
6.
Arch Phys Med Rehabil ; 104(6): 982-987, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36889374

RESUMO

Anti-Indigenous racism education and cultural safety training can help cultivate greater awareness and hold the potential to encourage Western-trained researchers to work in solidarity with Indigenous partners to resist the structural status quo. The purpose of this article is to provide an overview and author reflections on an immersive educational series "The Language of Research: How Do We Speak? How Are We Heard?". The series was developed by a Canadian group that included an Indigenous Knowledge Keeper, non-Indigenous researchers, and parent partners, all of whom have training or experience in Westernized research and/or health care. The 6-session virtual series was made available through a provincial pediatric neurodevelopment and rehabilitation research group in Canada. Participation was open to a broad audience, including but not limited to researchers, clinicians, families, and health-care professionals. This learning opportunity was developed as a starting point for ongoing integration of an anti-racism perspective within our provincial research group and began through conversation about how words or language typically used in Western approaches to research, ("recruit," "consent," "participant") could be unwelcoming, exclusionary, and harmful. Topics that were explored during the sessions included Using Descriptive Language/Communication; Relationships and Connection; and, Trust, Healing, and Allyship. The article aims to contribute to the ongoing dialogue related to disrupting racism and decolonizing research in the fields of neurodevelopment and rehabilitation. Reflections about the series are offered by the authorship team throughout the article, to solidify and share learning. We acknowledge this is only one of many steps in our learning.


Assuntos
Atenção à Saúde , Idioma , Humanos , Criança , Canadá , Pais , Comunicação
7.
J Assist Reprod Genet ; 40(2): 265-278, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36637586

RESUMO

PURPOSE: Staff management is the most cited ART/IVF laboratory inspection deficiency. Small ART/IVF clinics may be challenged to perform these activities by low staff volume; similarly, large ART/IVF networks may be challenged by high staff volume and large datasets. Here, we sought to investigate the performance of an automated, digital platform solution to manage this necessary task. METHODS: The ART Compass (ARTC) digital staff management platform was used to assess the clinical decision-making of ART laboratory staff. The survey modules presented standardized instructions to technologists and measured inter- and intra-technologist variability for subjective "clinical decision-making" type questions. Internal and external comparisons were achieved by providing technologists two answers: (1) a comparison to their own lab director and (2) to the most popular response collectively provided by all lab director level accounts. The platform is hosted on HIPAA compliant Amazon web servers, accessible via web browser and mobile applications for iOS (Apple) and Android mobile devices. RESULTS: Here, we investigated the performance of a digital staff management platform for single embryologist IVF practices and for three IVF lab networks (sites A, B, C) from 2020 to 2022. Embryology dish preparation survey results show variance among respondents in the following: PPE use, media volume, timing of oil overlay, and timing of moving prepared dishes to incubators. Surveying the perceived Gardner score and terms in use for early blastocysts reveals a lack of standardization of terminology and fair to poor agreement. We observed moderate inter-technologist agreement for ICM and TE grade (0.47 and 0.52, respectively). Lastly, the clinical decision of choice to freeze or discard an embryo revealed that agreement to freeze was highest for the top-quality embryos, and that some embryos can be highly contested, evenly split between choice to freeze or discard. CONCLUSIONS: We conclude that a digital platform is a novel and effective tool to automate, routinely monitor, and assure quality for staff-related parameters in ART and IVF laboratories. Use of a digital platform can increase regulatory compliance and provide actionable insight for quality assurance in both single embryologist practices and for large networks. Furthermore, clinical decision-making can be augmented with artificial intelligence integration.


Assuntos
Fertilização in vitro , Laboratórios , Humanos , Fertilização in vitro/métodos , Inteligência Artificial , Implantação do Embrião , Blastocisto , Reprodução
8.
J Zoo Wildl Med ; 53(2): 319-330, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35758573

RESUMO

Capillary zone electrophoresis (CZE) and an immunoassay for serum amyloid A (SAA) were used to examine serum samples from clinically normal and abnormal southern white rhinoceros (Ceratotherium simum simum) and southern black rhinoceros (Diceros bicornis minor) under managed care. CZE resolved seven fractions as well as subfractions for α1 globulins. Reference intervals were calculated for white rhinoceros (n = 33) and found to have some differences over previously reported intervals generated using agarose gel electrophoresis (AGE) methods in sera from free-ranging animals. In addition, the coefficient of variation related to fraction quantitation was found to be overlapping or superior to that reported for AGE. No significant differences were observed in CZE measurands and total protein between clinically normal and abnormal rhinoceros. In contrast to CZE, significant differences in SAA levels (P < 0.001) were observed in samples from the white rhinoceros between clinically normal and abnormal animals. In addition, in limited sample sets with repeated measures, SAA provided prognostic value. Future studies should generate more robust reference intervals and delineate the application of both SAA quantitation and CZE in routine health assessments and in prognostication.


Assuntos
Perissodáctilos , Proteína Amiloide A Sérica , Animais , Eletroforese em Gel de Ágar/veterinária , Eletroforese Capilar/veterinária , Valores de Referência
9.
Curr Opin Immunol ; 77: 102187, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35550259

RESUMO

Infection of mice with Borrelia burgdorferi (Bb), a tick-transmitted spirochete and the pathogen that causes Lyme disease in humans, triggers CD4 T cell activation in secondary lymphoid tissues, from which they disseminate into various infected tissues. Despite their activation and the appearance of CD4 T cell-dependent antibody responses, Bb establishes persistent infection in natural Bb reservoir hosts in the absence of overt disease, raising the question of the effectiveness of the anti-Bb T cell responses. Reviewing the existing literature, we propose that CD4 T cells might constitute a host cell target of Bb-mediated immune evasion, rendering these cells ineffective in orchestrating effective inflammatory responses and in supporting highly functional Bb-specific antibody induction. Supporting the induction of more effective CD4 T cell responses may help overcome Bb persistence.


Assuntos
Borrelia burgdorferi , Doença de Lyme , Animais , Anticorpos Antibacterianos , Linfócitos T CD4-Positivos , Humanos , Camundongos
10.
Phys Occup Ther Pediatr ; 42(5): 465-481, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35466859

RESUMO

AIMS: Pediatric occupational and physical therapy service delivery via telehealth increased during the COVID-19 pandemic. Real-world experience can guide service improvement. This study explored experiences, barriers, and facilitators of initial telehealth implementation from the therapist's perspective. METHODS: Qualitative descriptive approach. Semi-structured interviews were conducted with occupational therapists (n = 4) and physical therapists (n = 4) between May-June 2020. Interviews were recorded, and transcribed verbatim. Data were coded inductively to generate themes, then re-coded deductively to classify barriers and facilitators to telehealth acceptance and use using the Unified Technology Acceptance Theory. RESULTS: Participants had 16.5 [(2-35); median (range)] years of experience (3 months with telehealth) and predominantly worked with preschool children. Three themes about telehealth were identified: a practical option; requires skill development and refinement; beneficial in perpetuity. Most frequently cited barriers were the lack of opportunity for 'hands-on' assessment/intervention and the learning curve required. Most frequently cited facilitators included seeing a child in their own environment, attendance may be easier for some families, and families' perception that telehealth was useful. CONCLUSION: Despite rapid implementation, therapists largely described telehealth as a positive experience. Telehealth facilitated continued service provision and was perceived as relevant post-pandemic. Additional training and ensuring equitable access to services are priorities as telehealth delivery evolves.


Assuntos
COVID-19 , Fisioterapeutas , Telemedicina , Criança , Pré-Escolar , Humanos , Terapeutas Ocupacionais , Pandemias
11.
J Med Primatol ; 50(4): 219-221, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34111311

RESUMO

This study reports the occurrence of a poorly differentiated carcinoma in a captive-born 28 year-old male chimpanzee (Pan troglodytes) who has a familial history of cancer. Pathological findings, surgical interventions, and experimental treatments are discussed.


Assuntos
Carcinoma , Pan troglodytes , Animais , Masculino
12.
Fertil Steril ; 116(1): 114-122, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33752879

RESUMO

OBJECTIVE: To determine the dropout rate between the first and second in vitro fertilization (IVF) cycles in a controlled population derived from a funded and actively managed system of care in New Zealand, including the reason for dropout and associated cumulative live birth rate. DESIGN: Retrospective cohort. SETTING: Multicenter IVF practice. PATIENT(S): Couples qualifying for publicly funded IVF treatment under New Zealand's Clinical Priority Assessment Criteria. Couples (n = 974) started treatment between July 2011 and June 2013, used their own gametes, and were eligible for up to 2 IVF packages of funded care (including the transfer of surplus embryos). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): IVF dropout rate, reason for dropout, and cumulative live birth rate. RESULT(S): A low IVF dropout rate between the first and second IVF cycle was reported within this controlled IVF population, with 10% of couples discontinuing treatment for reasons related to stress. The cumulative live birth rate in this "low dropout" population was 59% at the end of treatment, ranging from 72% (≤30 years) to 42% (38-39 years) according to female age. Most patients who discontinued for stress had a good prognosis, and a third of patients still had embryos in cryostorage. Only 30% of those who discontinued used the funded counseling services. CONCLUSION(S): A low dropout rate (10%) can be achieved within an actively managed IVF population. This was lower than previously reported, suggesting that prognosis, cost, and treatment management are the significant causes of dropout within the general IVF population. Couples with many embryos also require psychological support because of treatment fatigue or repeated transfers.


Assuntos
Atenção à Saúde , Fertilização in vitro , Infertilidade/terapia , Pacientes Desistentes do Tratamento , Adulto , Atenção à Saúde/economia , Feminino , Fertilidade , Fertilização in vitro/economia , Custos de Cuidados de Saúde , Humanos , Infertilidade/diagnóstico , Infertilidade/economia , Infertilidade/fisiopatologia , Nascido Vivo , Masculino , Nova Zelândia , Gravidez , Taxa de Gravidez , Retratamento , Estudos Retrospectivos , Fatores de Tempo , Falha de Tratamento
13.
Reprod Biomed Online ; 42(4): 709-716, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33632655

RESUMO

Embryo quality is a key determinant of the success of IVF. Although the focus has been on selecting the best embryo for transfer, the classification of low-grade blastocysts (LGB) in existing scoring systems has received less attention. This is worrisome; embryo freezing allows optimal use of all created embryos, thus maximizing the cumulative live birth rate, which is arguably the most important outcome for infertile couples. A PubMed search was conducted in August 2020, using '((('poor-quality' OR 'poor quality') OR ('low-grade' OR 'low grade')) AND ('embryo' OR 'blastocyst')) AND ('pregnancy' OR 'live birth')'. This scoping review shows that LGB have similar euploidy and pregnancy success rates after implantation and have no adverse effects on pregnancy or perinatal outcomes. Evidence for pregnancy outcomes is lacking for different grades of LGB, with most studies clustering all LQB as one to compare with optimal blastocysts.


Assuntos
Blastocisto , Transferência Embrionária/normas , Feminino , Humanos , Gravidez , Taxa de Gravidez
14.
Hum Reprod ; 35(5): 1045-1053, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32358601

RESUMO

STUDY QUESTION: What is the inter-observer agreement among embryologists for decision to freeze blastocysts of borderline morphology and can it be improved with a modified grading system? SUMMARY ANSWER: The inter-observer agreement among embryologists deciding whether to freeze blastocysts of marginal morphology was low and was not improved by a modified grading system. WHAT IS KNOWN ALREADY: While previous research on inter-observer variability on the decision of which embryo to transfer from a cohort of blastocysts is good, the impact of grading variability regarding decision to freeze borderline blastocysts has not been investigated. Agreement for inner cell mass (ICM) and trophectoderm (TE) grade is only fair, factors which contribute to the grade that influences decision to freeze. STUDY DESIGN, SIZE, DURATION: This was a prospective study involving 18 embryologists working at four different IVF clinics within a single organisation between January 2019 and July 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS: All embryologists currently practicing blastocyst grading at a multi-site organisation were invited to participate. The survey was comprised of blastocyst images in three planes and asked (i) the likelihood of freezing and (ii) whether the blastocyst would be frozen based on visual assessment. Blastocysts varied by quality and were categorised as either top (n = 20), borderline (n = 60) or non-viable/degenerate quality (n = 20). A total of 1800 freeze decisions were assessed. To assess the impact of grading criteria on inter-observer agreement for decision to freeze, the survey was taken once when the embryologists used the Gardner criteria and again 6 months after transitioning to a modified Gardner criterion with four grades for ICM and TE. The fourth grade was introduced with the aim to promote higher levels of agreement for the clinical usability decision when the blastocyst was of marginal quality. MAIN RESULTS AND THE ROLE OF CHANCE: The inter-observer agreement for decision to freeze was near perfect (kappa 1.0) for top and non-viable/degenerate quality blastocysts, and this was not affected by the blastocysts grading criteria used (top quality; P = 0.330 and non-viable/degenerate quality; P = 0.18). In contrast, the cohort of borderline blastocysts received a mixed freeze rate (average 52.7%) during the first survey, indicative of blastocysts that showed uncertain viability and promoting significant disagreement for decision to freeze among the embryologists (kappa 0.304). After transitioning to a modified Gardner criteria with an additional grading tier, the average freeze rate increased (64.8%; P < 0.0001); however, the inter-observer agreement for decision to freeze was unchanged (kappa 0.301). Therefore, significant disagreement for decision to freeze among embryologists is an ongoing issue not resolved by the two grading criteria assessed here. LIMITATIONS, REASONS FOR CAUTION: Blastocyst assessment was performed from time-lapse images in three planes, rather than with a microscope in the laboratory. The inter-observer agreement for decision to freeze may be lower for embryologists working in different clinics with different grading protocols. WIDER IMPLICATIONS OF THE FINDINGS: The decision to freeze a blastocyst with borderline morphology is a common clinical issue that has the potential to arise for any patient during blastocyst culture. Disagreement for decision to freeze these blastocysts, and therefore clinical usability in frozen embryo transfer cycles, affects consistency in patient care due to a potential impact on cumulative live birth rates, as well as financial, emotional and time costs associated with the frozen embryo transfer cycles. We demonstrate significant disagreement for decision to freeze borderline blastocysts among embryologists using the same grading scheme within a large multisite organisation, a phenomenon which was not improved with a modified grading system. Decision-making around borderline embryos is an area requiring further research, especially as studies continue to demonstrate the reduced but modest live birth rates for low quality blastocysts (Grade C). These results provide support for emerging technology for embryo assessment, such as artificial intelligence. STUDY FUNDING/COMPETING INTEREST(S): None declared. TRIAL REGISTRATION NUMBER: Not applicable.


Assuntos
Inteligência Artificial , Implantação do Embrião , Blastocisto , Congelamento , Humanos , Estudos Prospectivos
15.
Neurorehabil Neural Repair ; 34(3): 235-246, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31976819

RESUMO

Background. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of taxane treatment and cannot currently be prevented or adequately treated. Physical therapy is often used for neural rehabilitation following injury but has not been evaluated in this patient population. Methods. Single-blind, randomized controlled exploratory study compared standard care to a physical therapy home program (4 visits) throughout adjuvant taxane chemotherapy for stage I-III patients with breast cancer (n = 48). Patient questionnaires and quantitative sensory testing evaluated the treatment effect throughout chemotherapy to 6 months post treatment. Nonrandomized subgroup analysis observed effect of general exercise on sensory preservation comparing those reporting moderate exercise throughout chemotherapy to those that did not exercise regularly. Clinical Trial Registration. clinicaltrials.gov (NCT02239601). Results. The treatment group showed strong trends toward less pain (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-1.01; P = .053) and pain decreased over time (OR 0.85, 95% CI 0.76-0.94; P = .002). Pain pressure thresholds (P = .034) and grip dynamometry (P < .001) were improved in the treatment group. For the nonrandomized subgroup analysis, participants reporting general exercise had preservation of vibration (Left P = .001, Right P = .001) and normal heat pain thresholds (Left P = .021, Right P = .039) compared with more sedentary participants. Conclusion. Physical therapy home program may improve CIPN pain in the upper extremity for patients with breast cancer, and general exercise throughout chemotherapy treatment was observed to have correlated to preservation of sensory function. Further research is required to confirm the impact of a physical therapy home program on CIPN symptoms.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Hidrocarbonetos Aromáticos com Pontes/efeitos adversos , Terapia por Exercício , Neuralgia/induzido quimicamente , Neuralgia/reabilitação , Reabilitação Neurológica , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/reabilitação , Taxoides/efeitos adversos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Método Simples-Cego
16.
J Zoo Wildl Med ; 51(3): 678-686, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33480545

RESUMO

This case series describes hepatocellular neoplasms in 10 Nile lechwe (Kobus megaceros) at two separate zoological institutions in Florida. Histologically, the neoplasms were classified as hepatocellular carcinoma (n = 7), hepatocellular adenoma (n = 2), and hepatobiliary carcinoma (n = 1). Common clinical signs were nonspecific and included thin body condition (n =7), lethargy (n =6), lameness (n =3), and acute recumbency (n =5). Four males and six females were affected, and the mean age at death was 12.7 yr with a range of 4-18 yr. All cases were diagnosed postmortem, and metastasis to various sites, including lung, lymph nodes, and omentum, was found in 40% of cases (n = 4). A single case of hepatocellular carcinoma in a Nile lechwe was described in 2007; however, this is the first reported series of neoplasms in Reduncinae. The pathogenesis behind the development of hepatocellular neoplasms in Nile lechwe has not yet been identified.


Assuntos
Adenoma de Células Hepáticas/veterinária , Antílopes , Carcinoma Hepatocelular/veterinária , Neoplasias Hepáticas/veterinária , Adenoma de Células Hepáticas/diagnóstico , Adenoma de Células Hepáticas/etiologia , Adenoma de Células Hepáticas/patologia , Animais , Animais de Zoológico , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/patologia , Feminino , Florida , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/patologia , Masculino , Estudos Retrospectivos
17.
J Epidemiol Community Health ; 74(2): 190-196, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31727789

RESUMO

BACKGROUND: The immediate and sustained impacts of the Eat Better Feel Better cooking programme (EBFBCP) on food choices and eating behaviours in families and children were evaluated. METHODS: The EBFBCP (6 weeks, 2 hours/week) was delivered by community-based organisations in Greater Glasgow and Clyde, Scotland. Before, after and at follow-up, parents/caregivers completed short pictorial questionnaires to report family/child eating behaviours and food literacy. RESULTS: In total, 83 EBFBCPs were delivered and 516 participants enrolled, of which 432 were parents and caregivers. Questionnaire completion rates were 57% (n=250) for before and after and 13% (n=58) for follow-up. Most participants (80%) were female, 25-44 years old (51%) and considered socioeconomically deprived (80%). The immediate effects of the EBFBCP on eating behaviours and food literacy were families ate less takeaway/fast foods (10% reduction, p=0.019) and ready meals (15% reduction, p=0.003) and cooked more from scratch (20% increase, p<0.001). Children's consumption of discretionary food/drinks was significantly reduced after the EBFBCP for sugary drinks (10% reduction, p=0.012), savoury snacks (18%, p=0.012), biscuits (17%, p=0.007), sweets/chocolates (23%, p=0.002), fried/roasted potatoes (17%, p<0.001) and savoury pastries (11%, p<0.001). The number of fruit (15%, p=0.008) and vegetable portions (10%, p<0.001) increased, while the number of biscuit portions decreased (13%, p=0.005). Parental food label reading increased (calories, 22%; fat, 23%; sugar, 22%; ingredients, 19%; and portion size, 19%). Most changes were sustained at a median of 10 months' follow-up. CONCLUSION: The EBFBCP improved children's and families' food choices and behaviours. The EBFBCP can be recommended to support families to make better food choices.


Assuntos
Culinária , Ingestão de Energia , Comportamento Alimentar , Preferências Alimentares , Pais/psicologia , Adulto , Criança , Pré-Escolar , Dieta Saudável , Feminino , Frutas , Promoção da Saúde , Humanos , Masculino , Refeições , Avaliação de Programas e Projetos de Saúde , Escócia , Fatores Socioeconômicos , Inquéritos e Questionários , Verduras
18.
Neurorehabil Neural Repair ; 33(10): 792-799, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31342880

RESUMO

One in 2 Canadians is expected to acquire cancer in their lifetime. Many cancers, including breast, ovarian, and lung cancer, are treated using taxane chemotherapy with curative intent. A major adverse effect with the use of taxane chemotherapeutic agents is taxane-induced peripheral neuropathy (TIPN). Both positive (spontaneous pain, heightened sensitivity with light touch, tingling, itching, burning) and negative (loss of touch, loss of hot/cold sensations, and loss of pain) sensory symptoms can be experienced in the hands and feet and worsen with increasing dose and treatment duration. The pathophysiology of TIPN is still unknown but likely involves multiple mechanisms, including microtubule impairment, neuroimmune and inflammatory changes, ion channel remodeling, impaired mitochondrial function, and genetic predisposition. This review highlights current theories on the pathophysiology for TIPN, the cellular responses thought to maintain neuropathic pain, and the growing support for exercise in the treatment and prevention of peripheral neuropathy and neuropathic pain in both animal and human models.


Assuntos
Antineoplásicos/efeitos adversos , Hidrocarbonetos Aromáticos com Pontes/efeitos adversos , Terapia por Exercício , Neoplasias/tratamento farmacológico , Neuralgia , Doenças do Sistema Nervoso Periférico , Taxoides/efeitos adversos , Humanos , Neuralgia/etiologia , Neuralgia/terapia , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/complicações , Doenças do Sistema Nervoso Periférico/terapia
20.
Can J Pain ; 3(1): 169-177, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-35005406

RESUMO

Aims: The aim of this study was to define the sensory phenotypes of taxane-induced peripheral neuropathy (TIPN) between neuropathic and nonneuropathic symptoms in a breast cancer population to identify future targets for mechanism-based pain management. Methods: Participants (n = 48) with stage I-III breast cancer. Self-report questionnaires and quantitative sensory testing were used to assess sensory symptoms. The self-report version of the Leeds Assessment for Neuropathic Symptoms and Signs (S-LANSS) divided the groups into neuropathic and nonneuropathic sensory phenotypes. In total, five visits over approximately 8 months assessed each participant from pre-chemotherapy to 6 months post-chemotherapy. Results: Out of 191 nerve assessments, 150 had an S-LANSS <12 defined as "nonneuropathic" and 41 scored >12, which was defined as "neuropathic." Numeric Pain Rating Scale (NPRS) was analyzed based on percentages of those experiencing 1+ pain (graded 1/10 or higher) versus no pain. The neuropathic group had 82.9% of 1+ pain vs. 28.7% in the nonneuropathic group (odds ratio = 7.49; 95% confidence interval, 2.76-20.3; P = 0.001). The neuropathic group reported impaired function on the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire (P = 0.002). Heat pain threshold resulted in statistical differences for the left hand but not the right hand in the neuropathic group (P = 0.05). No other quantitative data on warm/cool or cold or vibration demonstrated sensory differences between the groups. Conclusions: Few differences in sensory profiles measured using quantitative sensory testing (QST) were found. Heat pain thresholds were normalized, possibly suggesting that the neuropathic group retained C-fiber and transient potential vanilloid 1 (TRPV1) function. Participants with neuropathic pain demonstrated significant differences with increased pain and decreased function.


Objectif: Déterminer les phénotypes sensoriels associés à la neuropathie périphérique induite par le taxane dans une population de personnes atteintes de cancer du sein, selon qu'elles présentent des symptômes de neuropathie ou non, afin de déterminer les cibles futures pour la prise en charge de la douleur axée sur les mécanismes.Méthodes: Participants (n = 48) atteints d'un cancer du sein de stade I-III. Des questionnaires d'auto-évaluation et des tests sensoriels quantitatifs ont été utilisés pour évaluer les symptômes sensoriels. À l'aide de la version d'auto-évaluation de l'outil d'évaluation des symptômes et des signes de la douleur neuropathique de Leeds (S-LANSS), les groupes ont été divisés en phénotypes sensoriels avec neuropathie et sans neuropathie. Au total, cinq visites échelonnées sur une période d'environ huit mois ont permis d'évaluer chaque participant avant le début de la chimiothérapie jusqu'à six mois après le début de celle-ci.Résultats: 191 évaluations des nerfs, parmi lesquelles 150 participantes ont obtenu une note < 12 pour le S-LANSS, définis comme «sans neuropathie ¼, tandis que 41 participantes ont obtenu une note > 12, définie comme « avec neuropathie ¼. L'échelle numérique d'évaluation de la douleur a été analysée sur la base du pourcentage de participantes éprouvant une douleur égale ou supérieure à 1 (note de 1/10 ou plus) comparativement à aucune douleur. 82,9 % des patientes du groupe avec neuropathie éprouvaient une douleur égale ou supérieure à 1 comparativement à 28,7% pour le groupe sans neuropathie (RR = 7,49, CI 95 % 2,76-20,3, p = 0,001). Le groupe avec neuropathie a fait état d'une altération du fonctionnement selon le questionnaire DASH (p = 0,002). Des différences significatives ont été observées en ce qui concerne le seuil de la douleur thermique pour la main gauche, mais pas pour la main droite dans le groupe avec neuropathie (p = 0,05). Aucune autre donnée quantitative portant sur la sensibilité aux températures chaudes, tièdes ou froides, ou encore à la vibration, n'a révélé de différences sensorielles entre les groupes.Conclusions: On a constaté peu de différences entre les profils sensoriels mesurés par les tests sensoriels qualitatifs. Les seuils de douleur thermique ont été normalisés, ce qui indique probablement le maintien du fonctionnement des fibres de C et du TRPV1 chez le groupe avec neuropathie. Des différences significatives ont été observées chez les personnes souffrant de douleur neuropathique, dont une augmentation de la douleur et une diminution du fonctionnement.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA