Oxidized low-density lipoprotein in postmenopausal women.

BACKGROUND: Oxidized low-density lipoprotein (oxLDL) leads to atherosclerosis and cardiovascular disease, the most frequent causes of death worldwide. After menopause, lipid and lipoprotein metabolism changes and women are at greater risk of cardiovascular disease compared to fertile women. The aim of this study was to determine the prevalence of serum oxLDL in postmenopausal women and to identify possible associations of clinical and laboratory features with oxLDL in these patients. METHOD: After clinical examination and completing a clinical questionnaire, an ultrasound examination of both carotid arteries was conducted and blood was drawn from 533 postmenopausal women. oxLDL concentration was determined using proton NMR spectroscopy. RESULTS: Oxidized LDL was detected in 12.4% (95% confidence interval 9.7-15.5) of postmenopausal women with a median of 0.18 mg/dl (interquartile range 0.10-0.43). Although intima-media thickness did not differ, postmenopausal women with serous oxLDL had more often atherosclerotic plaques compared to women without oxLDL (6/66 vs. 0/467; P < 0.01). Higher concentrations of high-density lipoprotein, impaired glucose intolerance, and DBP were independently associated with the occurrence of oxLDL. If oxLDL was present, higher high-density lipoprotein and glucose intolerance were associated with higher concentrations of oxLDL. In contrast, higher blood urea concentrations were associated with lower concentrations of oxLDL. CONCLUSION: This study presents the prevalence and concentration of oxLDL in postmenopausal women and demonstrates that oxLDL concentration can be quantified by proton NMR spectroscopy in large patient samples. The data suggest that oxLDL may be a biomarker for incipient atherosclerotic changes in postmenopausal women. In contrary to the association of dyslipoproteinemia and diabetes, higher blood urea concentrations were associated with lower concentrations of oxLDL.

Successful treatment of primary chronic osteomyelitis in SAPHO syndrome with bisphosphonates.

The treatment of the painful osteomyelitis in patients with SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is often a problem. A 53-year-old woman had experienced palmo-plantar pustular skin lesions for four years, and in the past two years complained about progressive breath-and movement-dependent pain of the sternum. On examination she had extensive palmoplantar pustules and a painful swelling in the area of the right sternoclavicular joint. The three-phase bone scintigraphy showed a strong focal enrichment in the right sternoclavicular joint and at the transition from the manubrium to the corpus sterni suggesting active osteo-chondritis. Initially prednisolone and ibuprofen were administered, but only the skin changes regressed. The strong sternal pain decreased only after infusion of 4 mg zoledronic acid over three days. In a follow-up examination after five months the patient was still free of pain. The bisphosphonates inhibit osteoclastic activity and lead to long-lasting improvement of osteo-articular complaints in the SAPHO syndrome.

Effect of a woman's smoking status on oocyte, zygote, and day 3 pre-embryo quality in in vitro fertilization and embryo transfer program.

In the present study we investigated the effect of a woman's smoking status on the quality of the oocyte, zygote, and on day 3 pre-embryo, as well as the likelihood of achieving an ongoing pregnancy at 8 weeks. Smokers presented a higher number of nonfertilized oocytes than nonsmokers (20.1% vs. 10.8% of fertilization failure), by comparable clinical pregnancy rate for smokers (40.8%; 28/72) and for nonsmokers (39.2%; 23/58).

Serum estradiol/progesterone ratio on day of embryo transfer may predict reproductive outcome following controlled ovarian hyperstimulation and in vitro fertilization.

BACKGROUND: To determine whether estradiol-to-progesterone (E2/P) ratios at the time of embryo transfer (ET) have an effect on implantation and pregnancy in IVF cycles. METHODS: 239 women consecutively treated by IVF or ICSI were retrospectively analyzed and early luteal serum E2 and P were measured on the day of ET. Transfer occurred after a variable in vitro culture period ranging from 4-7 days after ovulation induction (OI). Following ET, serum E2/P ratios were calculated for clinical pregnancies, preclinical abortions and non-conception cycles. RESULTS: Receiver-operator curve analysis demonstrated that the E2/P ratio could differentiate between clinical pregnancies and non-pregnant cycles (area under the curve on OI +4 days = 0.70; 95% CI = 0.60-0.80; p = 0.003, on OI +5 days = 0.76; 95% CI = 0.64-0.88; p = 0.001, OI +7 days = 0.85; 95% CI = 0.75-0.96; p < 0.0001). CONCLUSION: These retrospective data may hold prognostic value regarding endometrial receptivity as reflected by E2/P measurements and may help improve IVF treatment outcome. Further prospective studies should be undertaken to confirm these obersveration.

Novel method for the cryopreservation of testicular sperm and ejaculated spermatozoa from patients with severe oligospermia: a pilot study.

OBJECTIVE: To investigate Volvox globator as an easy-to-handle vehicle and as a safe alternative for cryopreservation of functional motile sperm cells. DESIGN: Prospective, controlled, clinical pilot study. SETTING: Two in vitro fertilization (IVF) outpatient clinics for reproductive medicine. PATIENT(S): Fifteen patients with severe male infertility (density <100 motile sperm per milliliter) who were recruited from two IVF programs. The sperm cells were not intended for clinical use after thawing. INTERVENTION(S): In each case, a predetermined number (n = 8) of motile and morphologically intact sperm cells were injected into each Volvox sphere and then cryopreserved. The quality of the sperm cells and the handling of the Volvox spheres were verified. MAIN OUTCOME MEASURE(S): Postthaw recovery rate in cases of severe male infertility and the amount of motile sperm after thawing. RESULT(S): The postthaw recovery rate was 100%. At least 60% of the sperm cells were motile after thawing. CONCLUSION(S): The use of the spherical algae Volvox globator offers a promising, inexpensive, and easy approach to the cryopreservation of functional motile sperm cells. Volvox globator is an alternative in countries that prohibit the destructive use of oocytes, even after fertilization has failed.