RESUMO
RESEARCH QUESTION: Do women with endometriosis undergoing oocyte retrieval for fertility preservation experience the same level of pain as women undergoing oocyte retrieval for IVF? DESIGN: This retrospective cohort study included 796 cycles in women with endometriosis undergoing oocyte retrieval for fertility preservation (nâ¯=â¯401) or IVF (nâ¯=â¯395) between January 2020 and October 2022. Post-operative pain assessments were compared between the two groups using a numeric rating scale (NRS). RESULTS: Women in the fertility preservation group were younger (32.1 ± 4.2 years versus 35.1 ± 4.1 years; P < 0.001), had a lower body mass index (22.8 ± 3.9 kg/m2 versus 24.6 ± 4.4 kg/m2; P < 0.001) and had a lower concentration of anti-Müllerian hormone (1.8 ± 1.5 ng/ml versus 2.15 ± 2.11 ng/ml; Pâ¯=â¯0.026) in comparison with women in the IVF group. The oestrogen concentration on the day of ovulation trigger was higher in women in the fertility preservation group (2188 ± 1152 pg/ml versus 2081 ± 995 pg/ml; Pâ¯=â¯0.004), and the prevalence rates of adenomyosis and digestive endometrial lesions were lower in women in the fertility preservation group (14% versus 29%, P < 0.001; 16% versus 25%, Pâ¯=â¯0.003, respectively) compared with women in the IVF group. After oocyte puncture, more women in the fertility preservation group had an NRS pain score >3 (moderate to severe pain) compared with women in the IVF group (20% versus 14%; Pâ¯=â¯0.018). The progestin-primed ovarian stimulation (PPOS) protocol was identified as an independent predictive factor of greater post-operative pain (adjusted OR 2.30, 95% CI 1.06-5.15; Pâ¯=â¯0.039). CONCLUSION: Women with endometriosis undergoing fertility preservation reported more intense post-operative pain in the recovery room than women undergoing IVF. The PPOS protocol was an independent risk factor of intense pain (NRS pain score >3) in women with endometriosis, but further studies are needed to confirm this result.
Assuntos
Endometriose , Preservação da Fertilidade , Fertilização in vitro , Recuperação de Oócitos , Humanos , Feminino , Endometriose/complicações , Adulto , Preservação da Fertilidade/métodos , Estudos Retrospectivos , Fertilização in vitro/métodos , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/epidemiologia , Medição da DorRESUMO
Azoospermia, defined as the absence of sperm in the semen, is found in 10-15 % of infertile patients. Two-thirds of these cases are caused by impaired spermatogenesis, known as non-obstructive azoospermia (NOA). In this context, surgical sperm extraction using testicular sperm extraction (TESE) is the best option and can be offered to patients as part of fertility preservation, or to benefit from in vitro fertilization. The aim of the preoperative assessment is to identify the cause of NOA and evaluate the status of spermatogenesis. Its capacity to predict TESE success remains limited. As a result, no objective and reliable criteria are currently available to guide professionals on the chances of success and enable them to correctly assess the benefit-risk balance of this procedure. Artificial intelligence (AI), a field of research that has been rapidly expanding in recent years, has the potential to revolutionize medicine by making it more predictive and personalized. The aim of this review is to introduce AI and its key concepts, and then to examine the current state of research into predicting the success of TESE.
Assuntos
Inteligência Artificial , Azoospermia , Recuperação Espermática , Humanos , Azoospermia/diagnóstico , Azoospermia/cirurgia , Masculino , Resultado do Tratamento , Prognóstico , Valor Preditivo dos Testes , Testículo/patologia , Testículo/cirurgiaRESUMO
Following a year of regular unprotected intercourse with his partner, and without achieving pregnancy, Mr. L. turned to his general practitioner. A semen analysis was carried out and no spermatozoa was found. After being referred to a male infertility specialist, the patient underwent a second test and a comprehensive assessment of his azoospermia. The azoospermia was confirmed and the genetic investigation revealed aneuploidy..
Assuntos
Azoospermia , Infertilidade Masculina , Humanos , Masculino , Azoospermia/diagnóstico , Azoospermia/genética , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Análise do Sêmen , EspermatozoidesRESUMO
Since 1994, in France, bioethics law has set the regulatory framework for Medically Assisted Reproduction (MAR). The latest revision of the law of August 2, 2021, is characterized by major upheavals in the field of MAR and intervenes in several areas: the purpose and conditions to access to MAR, access to origins in the case of gamete or embryo donation, and gametes cryopreservation without medical indication. Indeed, the law authorizes, because of a strong societal demand, the extension of sperm donation to couples of women and unmarried women, as well as the possibility for any person to preserve his/her gametes if he/she meets the age criteria defined by decree. Finally, the law opens the possibility for people born following gamete or embryo donation to have access, from their 18th anniversary, to identifying and/or non-identifying data. These new measures have led to a very important number of MAR requests to fertility and donation centers, and have required the implementation of new circuits in order to harmonize care, without discrimination or prioritization.
Assuntos
Bioética , Técnicas de Reprodução Assistida , Humanos , Masculino , Feminino , Destinação do Embrião , Sêmen , BiologiaRESUMO
ABSTRACT: Ly, A, Strand, KL, Courtney, KJ, Barry, SS, Liscano, JA, Trebotich, TL, Martin-Diala, C, Martin, E, and Signorile, JF. Reliability of gallon-jug shelf-transfer test power equations in older women. J Strength Cond Res 37(5): 1124-1130, 2023-This study examined the test-retest reliability of the gallon-jug shelf-transfer (GJST) test as a measure of upper-body functional power in older women. Although the validity of the predictive equations for power during the GJST test has been established, for the test to be viable in either a laboratory or clinical environment, between-day and within-day reliability must be established. Thirty-four independently living older women (mean ± SD : 75.0 ± 6.4 years) performed 2 sets of 3 repetitions of the GJST test on 2 days separated by at least 48 hours. Using the established predictive equations, the values for peak power and average power were then computed. Statistical analyses to assess reliability included intraclass correlation coefficient, coefficient of variation (CV), SEM , minimal detectable change (MDC), and Cronbach's α values. Furthermore, Bland-Altman plots evaluated the agreement between the tests. Intraclass correlation coefficient (>0.91, p < 0 001), CV (<8.1%), SEM (<5.94 W), MDC (<14 W), and Cronbach's α (>0.95) indicated excellent reliability. The lines of equality for all Bland-Altman plots fell within the 95% confidence interval of the mean difference, implying that there were no significant differences between tests. Furthermore, bias values were small (<11.15 W), and the limits of agreement (LOA) were within an acceptable range. Based on our statistical analyses, the GJST test is a highly reliable assessment for determining object transfer power for healthy older women.
Assuntos
Nível de Saúde , Humanos , Feminino , Idoso , Reprodutibilidade dos TestesRESUMO
ABSTRACT: Strand, KL, Ly, AS, Barry, SS, Liscano, JA, Trebotich, TL, Martin-Diala, C, Martin, E, and Signorile, JF. Validity and reliability of the seated medicine ball throw as a measure of upper body power in older women. J Strength Cond Res 37(4): 902-908, 2023-In women, aging is associated with diminishing upper body power, which may increase the risk of falls and fall-related injury; however, the validity and reliability of clinical tests to evaluate upper body power need to be confirmed. The seated medicine ball throw (SMBT) is an upper body performance test used to monitor muscle function among older individuals. The purpose of this study was to evaluate the validity and test-retest reliability of the SMBT in older women. Thirty-five women (age = 75.15 ± 6.39 years) participated in this study. Subjects performed SMBT trials using common ball masses (SMBT 4lb and SMBT 3kg ) over 3 sessions. Familiarization with the SMBT and chest press 1 repetition maximum (CP 1RM ) was provided on the first day. On day 2, subjects repeated the tests, but data were recorded. On day 3, SMBT was retested followed by an evaluation of chest press peak power (CP PP ) values at 30-80% of CP 1RM . Significant correlations ( p ≤ 0.05) were found between the CP PP and SMBT 4lb ( r = 0.775, p < 0.001) and SMBT 3kg ( r = 0.734, p < 0.001), and SMBT distance showed expected declines with age ( r = -0.724 to -0.626, p < 0.001), demonstrating its validity. High reliability between testing days was found, and Bland-Altman plots showed few points that fell outside the limits of agreement. In conclusion, the SMBT is a valid and highly reliable tool that can be used by health professionals to monitor deficits in upper body muscular power to improve treatment protocols in older women.
Assuntos
Força Muscular , Treinamento Resistido , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Reprodutibilidade dos Testes , Força Muscular/fisiologia , Envelhecimento , Levantamento de Peso , Músculo Esquelético/fisiologia , Teste de Esforço/métodosRESUMO
Abattoir surveillance for Johne's disease monitoring in Australia has provided valuable feedback to producers about their flock's disease status since its commencement in 1999. The current surveillance system relies on the identification of gross lesions in sheep carcases at an abattoir, followed by sampling and histopathology testing. This manual inspection system has not been adapted to meet the changing disease situation, as infection prevalence levels have declined over time due to vaccination. This simulation study compares the current system with two alternative approaches utilising a validated quantitative (q)PCR method for the detection of Mycobacterium avium subsp. paratuberculosis in tissues, with random systematic sampling either alone or in conjunction with sampling of a single carcass presenting gross lesions. Consigned sheep were randomly simulated as either infected or uninfected according to defined prevalence levels of infection, with varying histopathological lesion severity and the presence or absence of gross lesions. These sheep were then allocated into multiple 'lines' (group of sheep slaughtered together) within each consignment, with each line subjected to testing with the three sampling strategies for the estimation of line and flock (consignment) sensitivity. The line sensitivity described the proportion of infected lines that tested positive, whereas the flock sensitivity was the proportion of consignments from the simulated infected flocks that had one or more lines test positive for paratuberculosis infection. The tissue qPCR strategy with gross lesion detection achieved marginally higher line sensitivity than the current abattoir surveillance strategy. The simulation of unvaccinated infected flocks with low to moderate prevalence levels demonstrated similar flock sensitivity for all three sampling models. However, the current strategy had very low line sensitivity for the simulated vaccinated infected flocks when the infection prevalence level was <2%. There were substantial differences in flock sensitivity between the two tissue qPCR approaches and the current abattoir surveillance strategy for vaccinated infected flocks, whereas, only marginal differences in flock sensitivity were evident between the two tissue qPCR models. Our results demonstrate that the current strategy is not effective at identifying infected animals at very low infection prevalence levels. The tissue qPCR approach investigated in this study is better as it removes the reliance on meat inspectors to identify gross lesions and can also assist in identifying flocks that have subclinical infected sheep not displaying gross lesions. Therefore, the sheep industry may benefit from incorporating tissue qPCR for Johne's disease surveillance, however the logistics and costs of conducting this type of testing would need to be considered prior to implementing any changes.
Assuntos
Paratuberculose , Reação em Cadeia da Polimerase em Tempo Real , Doenças dos Ovinos , Matadouros , Animais , Austrália/epidemiologia , Paratuberculose/diagnóstico , Paratuberculose/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Ovinos , Doenças dos Ovinos/diagnóstico , Doenças dos Ovinos/epidemiologiaRESUMO
BACKGROUND: Klinefelter syndrome (KS) is the most common cause of genetic male infertility, as most patients present azoospermia. In the testis, a massive decrease in the number of germinal cells is observed and this can begin early in childhood. Thus, it is possible to collect spermatozoa after sperm collection or thanks to testicular sperm extraction (TESE), but the chances finding spermatozoa are decreasing with the age. Sperm collection or TESE should be performed as early as possible. When KS is diagnosed during childhood or teens, fertility preservation could be beneficial. The minimal age for proposing fertility preservation remains controversial and there is no current recommendation about fertility preservation in young men with KS. DESIGN: In this context, we have conducted a systematic review of the results of fertility preservation in young patients with KS to discuss the optimal age range for offering fertility preservation, including or not a TESE. RESULTS: Six articles were included in the systematic review, with patients between 13 and 24 years-old. Except for one, all young men agreed for sperm collection following masturbation. Azoospermia was diagnosed in all patients presenting homogenous KS. One study reported the presence of spermatozoa in the ejaculate of a young man with mosaic KS. Fifty-eight young man for whom ejaculated sperm collection was unsuccessful have benefited from TESE. Testicular spermatozoa were found and frozen in 27 patients out of the 58 (46.5%). The chances of freezing viable testicular sperm between 14 and 23 years of age do not appear to depend on age. CONCLUSION: Fertility preservation should be proposed in young men, but the optimal age for proposing the first sperm collection could be adapted according to the medical context and the psychological maturity of the young man.
Assuntos
Infertilidade Masculina/prevenção & controle , Síndrome de Klinefelter/complicações , Adolescente , Preservação da Fertilidade/métodos , Humanos , Infertilidade Masculina/etiologia , Masculino , Adulto JovemRESUMO
Ovine Johne's disease is a chronic debilitating disease of sheep caused by Mycobacterium avium subsp. paratuberculosis (Mptb) which results in diarrhoea, emaciation and mortalities in infected animals. Vaccination with Gudair® has been a key strategy for controlling the disease in Australia since its approval in 2002. Previous research conducted in Australia has demonstrated that the vaccine is quite effective in reducing sheep mortalities. While some farms have also been successful in reducing the prevalence of the disease in their flocks to undetectable levels, sheep in other flocks continue to shed Mptb in faeces even after an ongoing vaccination program . This study was conducted to investigate management, husbandry and biosecurity factors associated with paratuberculosis infection in Gudair® vaccinated sheep flocks in Australia. We enrolled 64 sheep farmers and interviewed them to obtain information about their management and biosecurity practices. Pooled faecal samples were collected from sheep at each farm and cultured to create two outcome variables: Mptb positive (yes/no) and disease prevalence level (nil, < 1 %, ≥ 1 %). Binary and ordinal logistic regression analyses were conducted to evaluate the association of management, husbandry and biosecurity factors with these outcome variables. Farms were more likely to have Mptb positive sheep and a higher disease prevalence in their flocks if they: (a) provided supplementary feed on the ground (instead of in a trough); (b) had a greater number of neighbours with sheep; and (c) had introduced rams from a greater number of sources. The results suggest the effectiveness of Gudair® vaccination to control OJD can be improved if sheep producers maintain other risk management strategies and biosecurity practices. Extension agencies should advise farmers not to relax their biosecurity practices and to purchase rams from only low-risk sources, even if they are continuing to vaccinate their flocks.
Assuntos
Vacinas Bacterianas , Paratuberculose , Doenças dos Ovinos , Animais , Austrália/epidemiologia , Masculino , Mycobacterium avium subsp. paratuberculosis/imunologia , Paratuberculose/epidemiologia , Paratuberculose/prevenção & controle , Ovinos/microbiologia , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/prevenção & controleRESUMO
Johne's disease is a chronic intestinal disease affecting livestock. It leads to the shedding of Mycobacterium avium subspecies paratuberculosis (MAP) in the faeces, wasting and eventually death, with animal welfare, economic, and trade implications. The Johne's Beef Assurance Scheme, used in Australia to determine the risk of Johne's disease on beef properties and facilitate trade, is based on testing a subset of the herd with pooled faecal quantitative PCR. This study aimed to model the herd-sensitivity of pooled faecal testing under different Australian farming scenarios. Animals from simulated herds were randomly sampled and allocated into their respective pools. Each tested pool was provided a test outcome, with herd-sensitivity estimated as the probability of detecting a truly infected herd. The models simulated the test performance for the 'Sample' and 'Check' tests used in the assurance schemes (recommended sample sizes of 300 and 50, respectively) for a range of herd sizes, infection prevalence and MAP faecal shedding levels for the pool sizes of 5, 10, 15 and 20. Sensitivity and specificity input values of each pool size were obtained from a previous laboratory investigation. The herd-sensitivity estimate increased with herd size and infection prevalence levels, regardless of the pool size. Higher herd-sensitivity was also achieved for testing scenarios involving larger sample sizes. A pool size of 10 achieved similar herd-sensitivity to that of the current pool size for the majority of the Sample test and Check test scenarios. This was particularly evident when pool-specificity was assumed to be perfect. The overall herd-sensitivity of the Check test was very low for all infection prevalence levels and pool sizes, but it more than doubled, when the sample size increased from 50 to 100 animals (11% versus 26% for a herd size of 500 cattle with a 2% infection prevalence). The results show that the majority of beef producers participating in the assurance scheme can benefit from using a larger pool size for the pooled faecal quantitative PCR testing of their herd, in comparison to the pool size currently used.
Assuntos
Doenças dos Bovinos , Mycobacterium avium subsp. paratuberculosis , Paratuberculose , Animais , Austrália/epidemiologia , Bovinos , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/epidemiologia , Simulação por Computador , Ensaio de Imunoadsorção Enzimática/veterinária , Fezes , Paratuberculose/diagnóstico , Paratuberculose/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Aberrancies in fetal DNA methylation programming may modify disease susceptibility of the offspring. Maternal folate status has potential to alter fetal DNA methylation. OBJECTIVES: We examined the association of maternal and cord blood concentrations of folate and unmetabolized folic acid (UMFA), vitamin B-12, vitamin B-6, and choline with fetal DNA methylation and hydroxymethylation and assessed potential modifying effects of 38 fetal genetic variants in 22 genes. METHODS: Nutrient blood concentrations were measured in 368 pregnant women in early pregnancy (12-16 wk of gestation) and at delivery (37-42 wk of gestation) and in cord blood. DNA methylation and hydroxymethylation in cord blood mononuclear cells were quantified by LC-MS/MS. Pearson partial correlations were used to determine the association between individual nutrients and DNA methylation and hydroxymethylation. RESULTS: Serum and RBC folate and plasma UMFA concentrations (primary outcomes) in early pregnancy, at delivery, and in cord blood were not significantly associated with fetal DNA methylation. In contrast, maternal RBC folate in early pregnancy (r = -0.16, P = 0.04) and cord plasma UMFA (r = -0.23, P = 0.004) were inversely correlated with fetal DNA hydroxymethylation. Neither maternal and cord blood concentrations of other nutrients nor fetal genotypes (secondary outcomes) were significantly associated with fetal DNA methylation or hydroxymethylation. Infants born to mothers with RBC folate concentrations in the highest quartile and serum vitamin B-12 concentrations in the lowest quartile in early pregnancy had significantly lower fetal DNA methylation and higher birth weight compared with those born to mothers with lower RBC folate and higher serum vitamin B-12 concentrations (P = 0.01). CONCLUSIONS: Maternal and cord blood folate concentrations are associated with fetal DNA hydroxymethylation, but not DNA methylation, in a cohort of pregnant Canadian women. The observation that high folate and low vitamin B-12 maternal status in early pregnancy may be associated with decreased fetal DNA methylation and higher birth weight warrants further investigation. This trial was registered at clinicaltrials.gov as NCT02244684.
Assuntos
Metilação de DNA , DNA/metabolismo , Sangue Fetal/metabolismo , Feto/metabolismo , Ácido Fólico/sangue , Biomarcadores/metabolismo , Canadá , Cromatografia Líquida , Feminino , Humanos , Recém-Nascido , Gravidez , Espectrometria de Massas em TandemRESUMO
Bovine Johne's disease (JD) is a chronic debilitating disease affecting cattle breeds worldwide. Pooled faecal samples are routinely tested by culture to detect Mycobacterium avium subsp. paratuberculosis (Mptb) infection. More recently, a direct high throughput molecular test has been introduced in Australia for the detection of Mptb in faeces to circumvent the long culture times, however, the optimal pool size for beef cattle faeces is not known. This study aimed to determine the optimal pool size to achieve the highest test sensitivity and specificity for beef cattle. Individual archived faecal samples with low, medium and high quantities of Mptb (n = 30) were pooled with faecal samples from confirmed JD negative animals to create pool sizes of 5, 10, 15 and 20, to assess the diagnostic sensitivity relative to individual faecal qPCR. Samples from JD-free cattle (n = 10) were similarly evaluated for diagnostic specificity. Overall, 160 pools were created, with Mptb DNA extracted using magnetic bead isolation method prior to Mptb-specific IS900 quantitative PCR (qPCR). The pool size of 10 yielded the highest sensitivity 73% (95% CI: 54-88%), regardless of the quantity of Mptb DNA present in the faeces. There was no significant differences between the four different pool sizes for positive pool detection, however, there was statistical significance between low, medium and high quantities of Mptb. Diagnostic specificity was determined to be 100%. The increase in pool size greater than 10 increased the chances of PCR inhibition, which was successfully relieved with the process of DNA dilution. The results of this study demonstrate that the pool size of 10 performed optimally in the direct faecal qPCR. The results from this study can be applied in future simulation modelling studies to provide suggestions on the cost-effective testing for JD in beef cattle.
Assuntos
Doenças dos Bovinos/diagnóstico , Mycobacterium avium subsp. paratuberculosis/isolamento & purificação , Paratuberculose/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Animais , Austrália , Bovinos , DNA Bacteriano/genética , Fezes/microbiologia , Mycobacterium avium subsp. paratuberculosis/genética , Tamanho da Amostra , Sensibilidade e EspecificidadeRESUMO
Both insufficiency and excess of one-carbon nutrients (folate, choline, vitamins B6 and B12) during pregnancy have been associated with gestational diabetes mellitus (GDM). However, the precise nature of this association has not been clearly established. We hypothesized that GDM may affect one-carbon nutrients concentrations in the fetus, thus possibly participating in epigenetic programing of the offspring. Maternal blood was collected at recruitment (12-16 weeks). At delivery (28-42 weeks), both maternal and cord blood were collected. Blood concentrations of one-carbon nutrients and their metabolites were compared between the two groups. A total of 368 women were included in the study, of whom 19 (5.6%) were later diagnosed with GDM. No significant differences were found in maternal blood concentrations of one-carbon nutrients and their metabolites between the GDM and control groups at recruitment or at delivery. In cord blood, however, serum folate (87.7 [IQR 70.4-103.9] vs 66.6 [IQR 45.5-80.3] nmol/L, P = .025) and plasma TMAO (2.82 [IQR 1.3-3.2] vs 1.35 [IQR 1.0-2.0] µmol/L, P = .017) concentrations were higher, while plasma betaine concentrations were lower (17.5 [IQR 16.3-19.4] vs 21.1 [IQR 18.0-24.1] µmol/L, P = .019) in infants born to mothers with GDM compared with control. Our data suggest that while maternal blood concentrations of one-carbon nutrients and their metabolites may not affect the risk of GDM, GDM may alter concentrations of serum folate, plasma betaine and TMAO in cord blood. These alterations in one-carbon nutrient concentrations in fetal circulation may impact epigenetic programing, thereby contributing to physiologic changes and disease susceptibility in adulthood associated with GDM offspring.
Assuntos
Carbono/metabolismo , Diabetes Gestacional , Sangue Fetal/metabolismo , Feto , Nutrientes/metabolismo , Estado Nutricional , Complexo Vitamínico B/sangue , Adulto , Betaína/sangue , Colina/sangue , Diabetes Gestacional/fisiopatologia , Feminino , Desenvolvimento Fetal , Ácido Fólico/sangue , Humanos , Recém-Nascido , Gravidez , Cuidado Pré-Natal , Vitamina B 12/sangue , Vitamina B 6/sangueRESUMO
OBJECTIVE: Emergency contraception (EC) includes hormonal pills (levonorgestrel or ulipristal acetate) and the copper IUD (Cu-IUD). The Cu-IUD is more effective for EC than hormonal pills but remains underused, possibly because of lack of knowledge or interest. The objective of this study was to examine knowledge of and interest in the Cu-IUD for EC among Canadian women seeking EC. METHODS: The study used a cross-sectional convenience survey of English-speaking women presenting for EC at two sexual health clinics in Toronto. The anonymous paper-based survey was completed in the waiting room. The main outcome measures were women's knowledge of and interest in the Cu-IUD for EC. Demographic and reproductive health data were also collected. RESULTS: Between January and December 2013, 124 surveys were completed. Mean age of respondents was 26 years (SD ± 6.9). Most were single (85%), and over one half had completed postsecondary education. Overall, 77% had heard of the Cu-IUD, but only 21% were aware of its use for EC. Over 50% were aware that the Cu-IUD is hormone-free and may be used for long-term contraception. Women were less familiar with the window of administration of the Cu-IUD for EC (26%) and its efficacy (6%). In total, 23% (28 of 124) of women were interested in the Cu-IUD, including eight women scheduled to receive one that day. CONCLUSION: Women presenting for EC were unaware of the Cu-IUD but were moderately interested in it once informed. Public education and routine counselling about the Cu-IUD at EC visits may increase the uptake of this method.
Assuntos
Anticoncepção Pós-Coito/instrumentação , Conhecimentos, Atitudes e Prática em Saúde , Dispositivos Intrauterinos de Cobre , Adulto , Estudos Transversais , Feminino , Humanos , Adulto JovemRESUMO
Vitamin B6 is important in fetal development, but little is known of the vitamin B6 status of pregnant women and newborns in North America and potential modifying factors. This prospective study determined maternal and cord plasma concentrations of pyridoxal 5' phosphate (PLP; an indicator of vitamin B6 status) in a convenience sample of 368 Canadian pregnant women and their newborns. The association of maternal intake of vitamin B6 and fetal genetic variants with cord plasma PLP and homocysteine concentrations was also examined. Dietary and supplemental intakes of vitamin B6 were assessed in early and mid to late pregnancy. PLP concentrations were measured in maternal plasma in early pregnancy and at delivery, and in cord plasma. Six fetal variants of the MTHFR and CßS genes were assessed for their association with cord plasma PLP and homocysteine concentrations. Geometric mean (95% CI) PLP concentrations were 107 (98, 116) nmol/L in early pregnancy and 58 (53, 62) nmol/L at delivery, respectively, and 296 (275, 319) nmol/L in cord blood (p < .0001). During early pregnancy and at delivery, 3.6% and 5.5% of women had plasma PLP concentrations <20 nmol/L, respectively. Ninety eight percent of the women with supplemental B6 intake of at least the recommended dietary allowance had PLP concentrations >20 nmol/L. Fetal genetic variants were not associated with cord PLP and homocysteine concentrations. Vitamin B6 deficiency is uncommon in a cohort of Canadian pregnant women due largely to prevalent vitamin B6 supplement use.
Assuntos
Dieta Saudável , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição Materna , Cooperação do Paciente , Fosfato de Piridoxal/sangue , Saúde da População Urbana , Deficiência de Vitamina B 6/prevenção & controle , Adulto , Estudos de Coortes , Dieta Saudável/etnologia , Feminino , Sangue Fetal/química , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente/etnologia , Recém-Nascido , Masculino , Fenômenos Fisiológicos da Nutrição Materna/etnologia , Inquéritos Nutricionais , Ontário/epidemiologia , Cooperação do Paciente/etnologia , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etnologia , Complicações na Gravidez/prevenção & controle , Prevalência , Fosfato de Piridoxal/deficiência , Saúde da População Urbana/etnologia , Vitamina B 6/uso terapêutico , Deficiência de Vitamina B 6/sangue , Deficiência de Vitamina B 6/epidemiologia , Deficiência de Vitamina B 6/etnologia , Adulto JovemRESUMO
Canine parvovirus (CPV-2) remains an important cause of devastating enteritis in young dogs. It can be successfully prevented with live attenuated CPV-2 vaccines when given at the appropriate age and in the absence of maternal antibody interference. Rapid diagnosis of parvoviral enteritis in young dogs is essential to ensuring suitable barrier nursing protocols within veterinary hospitals. The current diagnostic trend is to use multiplexed PCR panels to detect an array of pathogens commonly responsible for diarrhea in dogs. The multiplexed PCR assays do not distinguish wild from vaccine CPV-2. They are highly sensitive and detect even a low level of virus shedding, such as those caused by the CPV-2 vaccine. The aim of this study was to identify the CPV-2 subtypes detected in diagnostic specimens and rule out occult shedding of CPV-2 vaccine strains. For a total of 21 samples that tested positive for CPV-2 in a small animal fecal pathogens diagnostic multiplexed tandem PCR (MT-PCR) panel during 2014-2016 we partially characterized the VP2 gene of CPV-2. Vaccine CPV-2 strain, wild type CPV-2a subtypes and vaccine-like CPV-2b subtypes were detected. High copy number was indicative of wild-type CPV-2a presence, but presence of vaccine-like CPV-2b had a variable copy number in fecal samples. A yardstick approach to a copy number or Ct-value to discriminate vaccine strain from a wild type virus of CPV-2 can be, in some cases, potentially misleading. Therefore, discriminating vaccine strain from a wild type subtype of CPV-2 remains ambitious.
Assuntos
Doenças do Cão/prevenção & controle , Infecções por Parvoviridae/prevenção & controle , Parvovirus Canino/imunologia , Vacinas Virais/administração & dosagem , Animais , Doenças do Cão/imunologia , Doenças do Cão/virologia , Cães , Fezes/virologia , Reação em Cadeia da Polimerase Multiplex , Infecções por Parvoviridae/imunologia , Infecções por Parvoviridae/virologia , Parvovirus Canino/patogenicidade , Vacinas Atenuadas/administração & dosagemRESUMO
Purpose: This article describes gluteus medius and minimus muscle thickness and hip abductor strength and function in healthy adults and explores the relationships between muscle thickness and function. Methods: Gluteus medius and minimus muscle thickness (B-mode ultrasound), isometric hip abductor strength (Biodex dynamometer), and lower extremity function (timed Trendelenburg test, Five-Times-Sit-to-Stand Test [FTSST], and lateral step-down test) were measured in healthy adults using a cross-sectional study design. Results: A total of 22 subjects were included: 10 men and 12 women, mean age 25.2 (SD 3.1) years, mean BMI 22.9 (SD 3.5) kilograms per metre squared. Muscle thickness of the gluteals was a mean 3.88 (SD 0.13) centimetres, and mean hip abductor peak torque was 111 (SD 43) newton-metres. FTSST mean time was 5.3 (SD 0.2) seconds, and median scores were 2.0 points for lateral step-down and 90 seconds for timed Trendelenburg. No significant relationships were found between gluteal muscle thickness and functional tests (rs=-0.28 to 0.37, ps=0.09-0.80) or strength (r=-0.24, p=0.28). Conclusion: Although hip abductors are key pelvic stabilizers for functional movements, gluteal muscle thickness was not associated with strength or function. This may be a result of agonist muscle activity, leading to an inability to isolate the gluteals, and to the ceiling effects of the functional tests.
Objectif : décrire l'épaisseur du muscle moyen glutéal et du muscle petit glutéal, la force et la fonction de l'abducteur de la hanche chez des adultes en santé et explorer les liens entre l'épaisseur et la fonction des muscles. Méthodologie : les chercheurs ont mesuré l'épaisseur du muscle moyen glutéal et du muscle petit glutéal (échographie en mode B), la force de l'abduction isométrique de la hanche (dynanomètre Biodex) et la fonction des jambes (test de Trendelenburg chronométré, test fonctionnel assis-debout de cinq répétitions [FTSST] et tests de descente latérale des marches) chez des adultes en santé dans le cadre d'une étude transversale. Résultats : au total, 22 sujets ont participé, soit 10 hommes et 12 femmes d'un âge moyen de 25,2 ans (ÉT 3,1 ans), d'un IMC moyen de 22,9 kg/m2 (ÉT 3,5 kg/m2). L'épaisseur moyenne des muscles glutéaux était de 3,88 cm (ÉT 0,13 cm), et la puissance de pointe moyenne de l'abducteur de la hanche, de 111 newton-mètres (ÉT 43 Nm). La durée moyenne du FTSST était de 5,3 secondes (ÉT 0,2 s), tandis que le score médian du test de descente latérale des marches était de 2,0 points, et celui du test de Trendelenburg chronométré, de 90 secondes. Il n'y avait pas de relation significative entre l'épaisseur des muscles glutéaux et les tests fonctionnels (r=−0,28 à +0,37, p=0,09 à 0,80) ou la force (r=−0,24, p=0,28). Conclusion : même si les abducteurs de la hanche sont des stabilisateurs essentiels du bassin lors des mouvements fonctionnels, l'épaisseur des muscles glutéaux ne s'associait ni à la force ni à la fonction. Ce peut être à cause de l'activité des muscles agonistes qui empêche d'isoler les muscles glutéaux, de même que des effets plafonds des tests fonctionnels.
RESUMO
Maternal folic acid supplementation can alter DNA methylation and gene expression in the developing fetus, which may confer disease susceptibility later in life. We determined which gestation period and organ were most sensitive to the modifying effect of folic acid supplementation during pregnancy on DNA methylation and gene expression in the offspring. Pregnant rats were randomized to a control diet throughout pregnancy; folic acid supplementation at 2.5× the control during the 1st, 2nd or 3rd week of gestation only; or folic acid supplementation throughout pregnancy. The brain, liver, kidney and colon from newborn pups were analyzed for folate concentrations, global DNA methylation and gene expression of the Igf2, Er-α, Gr, Ppar-α and Ppar-γ genes. Folic acid supplementation during the 2nd or 3rd week gestation or throughout pregnancy significantly increased brain folate concentrations (P<.001), while only folic acid supplementation throughout pregnancy significantly increased liver folate concentrations (P=.005), in newborn pups. Brain global DNA methylation incrementally decreased from early to late gestational folic acid supplementation and was the lowest with folic acid supplementation throughout pregnancy (P=.026). Folic acid supplementation in late gestation or throughout pregnancy significantly decreased Er-α, Gr and Ppar-α gene expression in the liver (P<.05). The kidney and colon were resistant to the effect of folic acid supplementation. Maternal folic acid supplementation affects tissue folate concentrations, DNA methylation and gene expression in the offspring in a gestation-period-dependent and organ-specific manner.