RESUMO
Assisted human reproduction has undergone rapid advances since its inception 45 years ago. To keep pace with these advances, assisted reproduction laboratories should adhere to a quality management system that addresses staffing and training, physical space and air quality, equipment maintenance and other operational matters, and ensures gamete and embryo handling in accordance with the latest quality and safety standards. Accordingly, this review aims to provide a reference document that highlights the critical aspects to consider when establishing and operating an ART laboratory. The review collates and expands upon published national and international guidelines and consensus documents, providing easier access to this large body of important information.
Assuntos
Opinião Pública , Técnicas de Reprodução Assistida , Humanos , Laboratórios , Reprodução , TecnologiaRESUMO
OBJECTIVE: To assess thoracic aortic intima-media thickness (aIMT) as a marker of thoracic aortic remodeling in children born small for gestational age (SGA). STUDY DESIGN: We assessed thoracic aIMT, carotid intima-media thickness (cIMT), and pulse wave velocity (PWV) in 239 patients (117 SGA; 122 appropriate for gestational age controls) age 6-8 years. Each SGA participant was matched 1:1 based on sex, gestational age, and birth date. Thoracic aIMT was determined by 2-dimensional transthoracic echocardiography. RESULTS: SGA children showed a significant increase in both aIMT (0.89 mm [0.12] vs 0.79 mm [0.11], P < .001) and cIMT (.50 mm [0.05] vs 0.49 mm [0.04], P < .001) compared with appropriate for gestational age controls, but the magnitude of the difference in aIMT was greater than that in cIMT (standardized difference of the means: +84% vs +27%). aIMT was linearly correlated with aortic arch PWV as measured by echocardiography (r = 0.211, P < .001) but not with carotid-femoral PWV (r = 0.113, P = .111). Born SGA was independently associated with increased aIMT after controlling for perinatal, anthropometric, and biochemical determinants in linear regression models. CONCLUSIONS: SGA children exhibit increased thoracic aIMT and aortic arch PWV in early childhood that may suggest the presence of structural changes in the thoracic aorta wall architecture. Measurement of ascending aIMT by transthoracic echocardiography is feasible and reproducible and may be a useful marker of vascular disease.
Assuntos
Aorta Torácica/patologia , Doenças da Aorta/etiologia , Espessura Intima-Media Carotídea , Aorta Torácica/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Masculino , Análise de Onda de PulsoRESUMO
OBJECTIVE: The area of pediatric hypertension (HTN) research has seen substantial progress over the last two decades, but no bibliometric analysis has yet been undertaken to describe these advances. This study aims to describe the published research examining HTN in children and adolescents from 2000 to 2018. METHODS: Articles were retrieved using PubMed and the Web of Science. Analyses were performed to quantify the evolution of scientific output, identifying the leading journals, authors, and countries as well as the existing collaboration networks. Likewise, we identified the most cited articles, describing their document type, main topic focus, and the age of the patients studied. RESULTS: In total, we identified 8317 articles in the Web of Science. The annual number of publications doubled over the study period. Articles were published in 1415 journals, mainly in the categories of Peripheral & Vascular Diseases and Pediatrics. The USA dominated scientific production in the field. Regarding researcher productivity, the top 202 authors participated in 20% of the articles, and there were 47 stable research clusters, with the largest component made up of 17 authors. Altogether, there were 145 most cited articles, with an irregular annual distribution; about half focus on HTN itself, while the rest study associated disorders and conditions. CONCLUSION: This is the first study to analyze scientific output on HTN in children and adolescents. The snapshot that emerges is of a research area that is growing but is still in a relatively early phase of development.
Assuntos
Bibliometria , Hipertensão , Adolescente , Criança , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , AnamneseRESUMO
Over the past 2 years, new guidelines for hypertension in children and adults have been published. The first, developed by the European Hypertension Society Working Group on Hypertension in Children and Adolescents, recognised the need for an update of the of the 2009 European Guidelines of in order to incorporate the new information acquired over the last few years. Subsequently, an update of the American guidelines (the most recent of which was in 2004), has been published. In both guidelines there are aspects which are agreed on, and in others, there are marked differences in the basic elements that have an influence on daily clinical practice. The main differences are centred on the criteria for the diagnosis and classification of hypertension, with the subsequent impact on its prevalence. Future studies should offer responses to all the questions that still remain unresolved.
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Hipertensão/diagnóstico , Hipertensão/terapia , Guias de Prática Clínica como Assunto , Adolescente , Criança , Europa (Continente) , Humanos , Estados UnidosRESUMO
Novel next-generation sequencing procedures have rapidly emerged into the preimplantation genetic screening framework. This work presents the design and validation of a new low-coverage whole-genome sequencing assay for aneuploidy detection in single blastomeres and trophectodermal samples from preimplantation embryos. The validation ensures analytical sensitivity, specificity, robustness, precision, limit of detection, resolution, and reproducibility. Specific parameters to measure the performance are defined, and the results are compared with a standardized array-based method to stablish the concordance. From the single cell genomics point of view, the main novelties are the length of reads of the libraries (150 nucleotides) together with a paired-end strategy and the design of an original algorithm and copy number viewer. A total of 129 samples were included in six experimental runs using a MiSeq Illumina platform. Samples included: single amniocytes, single blastomeres (cleavage-stage embryos), trophectoderm samples (blastocyst), and diluted DNA. Sensitivity and specificity were calculated per chromosome yielding 96% and 99%, respectively. The percentage of concordant samples was 98.2% and all of the aneuploid samples were confirmed. In conclusion, the validation yields highly reliable and reproducible results, representing an accurate and cost-effective strategy for the routine detection of aneuploidy in human embryos.