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We investigate the charge-pickup cross section of 158A GeV 207Pb projectiles on Bi, Pb, Cu and Al targets using CR39 nuclear track detectors. The target-detector stacks were exposed at CERN SPS beam facility. Chemical etched detectors are scanned using optical microscope, and the data in the form of etched cone heights have been collected. We have identified the beam and fragment charge states in particular charge-pickup (Z = 83) by the Pb ions using the etched cone heights. Dependence of charge-pickup cross section of 158A GeV 207Pb projectiles on the target mass number is described and results are compared to similar measurements found in the literature. [ABSTRACT FROM AUTHOR]

There is great diversity in the practice of blood banking and transfusion medicine between countries. We sought to relate this to the variety of health care and blood supply systems in different countries. Questionnaires were completed by respondents from 15 countries selected from among those with higher Human Development Indices. These data were reviewed searching for correlations with blood banking and transfusion medicine practices. Wide varieties of health care and blood supply schemes were documented. There was no apparent relationship between their structure and organization nor their financing arrangements and their proclivity for the implementation of new methods or approaches such as pathogen inactivation and universal leucoreduction. The costs of the operation of the blood supply system as represented by their product fees and the rate of collection of red cells could also not be associated with the factors examined. The diversity of practice evident across developed countries is not explicable solely through their health care and blood supply system structures. Other factors are likely involved but are not easy to define or measure. [ABSTRACT FROM AUTHOR]

In this article the authors discuss various aspects of inventory management of blood transfusion products. It highlights inventory management practices and a range of different products which are provided for patients. The authors reflect a concern for the value of the blood products both in terms of their cost as well as in terms of their relative scarcity.

Background and Objectives Canadian consumption of intravenous immunoglobulin (IVIG) has increased dramatically since it was first marketed in the early 1980s, and Canada is now the world's largest per capita consumer. During the late 1990s, worldwide product shortages of IVIG occurred. This study was designed to identify the disease conditions for which IVIG was being prescribed in academic hospitals during this period, and to explore the effects that IVIG shortages had on prescribing patterns. Materials and Methods Blood bank and pharmacy records of IVIG distribution were collected retrospectively from four Toronto teaching hospitals for the period 1995–2000. These records were then cross-referenced with patient medical records to determine the indication for IVIG administration. Results A total of 100 208 g of IVIG was prescribed to 429 patients over a 6-year period. Most of the IVIG consumption was in patients with haematological (22%) or neurological (20%) conditions, in recipients of bone marrow transplants (19%) and in patients with infectious disease-related conditions (including congenital and acquired hypogammoglobulinaemia, 18%). Dermatological conditions (7%) were the most rapidly growing indication for IVIG usage during the 6-year period of review, increasing from 0% of annual IVIG usage in 1995 to 16% in 2000. Over 80% of the diseases treated were supported by published recommendations. After 1997 there was an abrupt decline in the annual number of patients treated, primarily owing to a decline in single-use recipients. Annual consumption of IVIG, however, remained stable. Conclusions IVIG shortages were followed by a decrease in the number of single-use recipients, who probably represented empirical use of IVIG; this had little effect on the total amount of IVIG distributed annually. Stricter adherence to currently available published recommendations may not be the optimal means of controlling IVIG use within an academic hospital setting. Rather, emphasis may be better placed on improving the evidence base upon which these recommendations are made, for example by conducting controlled prospective clinical trials. [ABSTRACT FROM AUTHOR]

Background: Embryo morphology and cleavage rates alone do not consistently identify embryos with high implantation potential following IVF. Blastocyst transfer has been reported to improve success rates by identifying potentially superior quality embryos. Algorithms for predicting IVF outcomes based on the presence of early developmental milestones have been proposed. Here we introduce the Graduated Embryo Score (GES).Methods: Nucleolar alignment along the pronuclear axis, regular cleavage and degree of fragmentation at the first cell division, and cell number and morphology on day 3 were weighted to create a possible GES of 100 for each of 1245 fertilized embryos derived from 109 patients aged <40 years. The GES was correlated with IVF outcome.Results: Of 983 embryos for extended culture, 349 (36%) developed to blastocyst and 180 (18%) were good quality (grade I-II). When ranked by cell number and morphology alone, 34% of embryos with > or =7 cells and <20% fragmentation formed good quality blastocysts. Using GES, embryos scoring 90-100 had 64% blastocyst formation compared with 31% scoring 70-85 and with 11% scoring 30-65. Embryos scoring 70-100 had 44% blastocyst development compared with 9% scoring 0-65. Fifty-six patients (51%) conceived on-going gestations from 294 transferred embryos. In patients with at least one transferred embryo scoring > or =70, the pregnancy rate was 59% compared with 34% if all embryos scored <70. The overall implantation rate was 28%. Among embryos scoring 70-100, an implantation rate of 39% was seen, compared with 24% among embryos scoring 0-65.Conclusions: Predicting which cleaved embryos will form blastocysts could permit the high success rates associated with blastocyst transfer to be achieved from day 3 embryo transfer. [ABSTRACT FROM AUTHOR]

Antiphospholipid antibodies (APA) have been identified in patients with recurrent pregnancy loss and IVF failure. Of these, antiphosphatidylethanolamine (aPE) and antiphosphatidylserine (aPS) may have special significance. A link between increased natural killer cell activity (NKa+) and trophoblast cell apoptosis has also been reported. This study was undertaken to determine how the APA profile was associated with peripheral NK cell activity. We evaluated 197 female IVF candidates for APA and NKa. Eighty-nine patients (45%) were APA+ and of these, 51 (57%) were aPE/aPS+. Fifty-four patients (27%) had increased NK cell activity. Some 51% of APA+ and 78% of aPE/aPS+ patients had increased NK cell activity compared with 8% and 13% when APA and aPE/aPS tested negative respectively (P: < 0.0001). Non-male factor infertility patients were APA+ and NKa+ in 57% and 34% of cases respectively, compared with 19% and 13% if a pure male factor was present. Some 88% of aPE/aPS+, non-male factor patients had increased NK cell activity, compared with 12% who tested aPE/aPS negative (P: < 0.0001) and 25% of aPE/aPS+, isolated male factor patients (P: < 0.0001). These findings establish a direct relationship between APA (specifically aPE/aPS) and increased peripheral NK cell activity among non-male factor infertility patients. It is possible that APA do not directly cause reproductive failure but rather function as markers or intermediaries for an underlying, abnormal activation of cellular immunity. [ABSTRACT FROM AUTHOR]

Endometrial growth is thought to depend on uterine artery blood flow and the importance of endometrial development on in-vitro fertilization (IVF) outcome has been previously reported. Nitric oxide (NO) relaxes vascular smooth muscle through a cGMP-mediated pathway and NO synthase isoforms have been identified in the uterus. Sildenafil citrate (Viagra), a type 5-specific phosphodiesterase inhibitor, augments the vasodilatory effects of NO by preventing the degradation of cGMP. In this preliminary report we describe the use of vaginal sildenafil to improve uterine artery blood flow and sonographic endometrial appearance in four patients with prior failed assisted reproductive cycles due to poor endometrial response. The uterine artery pulsatility index (PI) was measured in a mock cycle after pituitary down-regulation with Lupron. The PI was decreased after 7 days of sildenafil (indicating increased blood flow) and returned to baseline following treatment with placebo. The combination of sildenafil and oestradiol valerate improved blood flow and endometrial thickness in all patients. These findings were reproduced in an ensuing gonadotrophin-stimulated cycle. Three of the four patients conceived. Although greater numbers of patients and randomized evaluation are needed to validate this treatment, vaginal sildenafil may be effective for improving uterine artery blood flow and endometrial development in IVF patients with prior poor endometrial response. [ABSTRACT FROM AUTHOR]

This study was undertaken to explore whether intervention with heparin and aspirin (H/A) in selected patients undergoing in-vitro fertilization (IVF) and embryo transfer could improve fecundity rates. Specifically, it explored the possibility that women diagnosed with organic pelvic disease who demonstrated antiphospholipid antibodies (APA) could benefit from H/A administration in a similar manner to that used in patients with recurrent pregnancy loss. We used an enzyme-linked immunosorbent assay for six different phospholipids to identify patients who expressed APA before they underwent IVF/embryo transfer. This study was confined to the first IVF/embryo transfer cycle that followed assessment of APA status and accordingly, the number of IVF/embryo transfer cycles corresponds with the number of patients treated. APA seropositive patients were treated with aspirin, 81 mg orally q.d., and heparin 5000 IU s.c. b.i.d., beginning on day 1 of controlled ovarian stimulation. The endpoint for success was a live birth or an ultrasound confirming fetal cardiac activity (a viable pregnancy). The prevalence of APA in patients diagnosed with organic pelvic disease (53%) was much higher than in those without female pathology (14%). The administration of H/A to APA seropositive patients significantly (P < 0.05) improved the viable pregnancy rate (49%) compared to the untreated APA seropositive group (16%). The viable pregnancy rate for APA seropositive women treated with H/A was also significantly (P < 0.001) higher than for untreated APA seronegative patients (27%). We conclude that all women undergoing IVF/embryo transfer should be tested for APA prior to initiating ovarian stimulation and those with APA seropositivity should be treated with H/A. [ABSTRACT FROM AUTHOR]

This study reports on 330 women aged 29 to 45 years, who underwent 411 cycles of in-vitro fertilization and embryo transfer (IYF/ET). Vaginal sonograms were performed during the late proliferative phase of natural cycles and cycles of controlled ovarian hyperstimulation (COH) with gonadotrophins, to evaluate both the thickness and echogenicity of the endometrium. Findings classified as Grade I; characterized by homogeneous echogenicity of the endometrium, and Grade II; characterized by an outer peripheral layer of dense echogenicity surrounding a central sonolucent area (i.e. a ‘halo pattern’). Grades I and II were subclassified on the basis of thickness into A (≥9 mm) and B (<9 mm). Grade IIA (‘optimal’) was associated with a clinical pregnancy rate per embryo transfer of 33% while Grades IA, IB and IIB (‘poor’) were associated with a rate of only 7%. Women aged 41–45 years experienced a 25% incidence of ‘poor’ sonographic grades while the incidence in women ≤40 years of age was 5%. The presence of various uterine pathologies was associated with ‘poor’ endometrial grades in 86% of cases while only 11% of normal uteri manifested ‘poor’ grades. ‘Optimal’ endometrial grades in natural cycles were consistently associated with ‘optimal’ grades in ensuing cycles of COH (96%). Women with ‘poor’ endometrial grades in natural cycles improved in 55% of cases during subsequent COH. The results of this study indicate that sonographic assessment of the endometrial lining in the late proliferative phase during both natural and COH cycles is a valuable method for screening and managing IVF/ET candidates. [ABSTRACT FROM PUBLISHER]

Over a 4 year period ending 1 January 1995, 51 women scheduled for in-vitro fertilization (IVF) and embryo transfer were inadvertently severely overstimulated with menotrophins, as evidenced by the development of >29 ovarian follicles in association with peak plasma oestradiol concentrations of >6000 pg/ml. Accordingly, these women were at great risk of developing life-endangering complications associated with severe ovarian hyperstimulation syndrome (OHSS). Treatment involved withholding the administration of both menotrophins and human chorionic gonadotrophin for a number of days, while continuing gonadotrophin-releasing hormone agonist until the plasma oestradiol concentration fell to <3000 pg/ml (‘prolonged coasting’). The mean number of oocytes retrieved was 21.0, while the mean number of embryos transferred per procedure was 5.4. There were 21 clinical pregnancies (i.e. pregnancy rate of 41% per oocyte retrieval), 19 of which resulted in live births (i.e. a live birth rate of 37% per oocyte retrieval). Two pregnancies miscarried and there were four multiple gestations (three sets of twins and one set of triplets). None of the women developed severe OHSS. Prolonged coasting is an effective method of preventing the occurrence of severe OHSS without necessitating the cancellation of the IVF cycle or compromising success rates. [ABSTRACT FROM PUBLISHER]

Ovum donation and in-vitro fertilization (IVF) surrogacy can help couples with difficult infertility problems achieve pregnancy. Most centres using oral oestrogens and oestradiol patches report pregnancy rates in the range of 30% per cycle. Parenteral oestradiol valerate has pharmacological properties that make it an attractive option for preparing the endometrium in the recipients undergoing these procedures. When the egg providers were under age 35 years, and using oestradiol valerate in the recipients, we achieved a 61% clinical pregnancy rate in 62 cycles. These improved results suggest that parenteral oestradiol valerate should be used to prepare the endometrium in recipients, and that the hormonal milieu of the endometrium plays an important role in the higher implantation rates obtainable in ovum donor and IVF surrogate cycles. [ABSTRACT FROM AUTHOR]

A total of 816 women who underwent 1332 cycles of ovarian stimulation for in-vitro fertilization and embryo transfer (IVF/ET) had sonographic assessments of the endometrium within 2 days of oocyte retrieval. Endometrial linings were classified on the basis of thickness and echogenicity, using a grading system described previously. Grades I and IIB (‘poor’) were associated with a 6% viable pregnancy rate (advanced beyond 12 weeks' gestation) compared with a 29% rate for Grade IIA (’optimal‘). In a subset of 112 women with poor endometrial linings during natural cycles, eight out of 21 women (38%) under 40 years of age developed optimal linings following ovarian stimulation with menotrophins, while 19 out of 91 women (21%) aged 41–45 years converted to optimal linings. Twenty-two out of 47 women (44%) who failed to develop optimal endometrial linings following ovarian stimulation converted to Grade IIA during subsequent cycles of exogenous oestrogen replacement. The financial, emotional, and physical burden associated with IVF/ET demands that patients with poor endometrial linings following ovarian stimulation with menotrophins be counselled with regard to either cancelling their cycles of treatment, or having their embryos cryopreserved for transfer to the uterus during a subsequent hormonal replacement cycle. [ABSTRACT FROM PUBLISHER]

The article discusses findings of a study in 2002, which examined the effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. The retrospective analysis involved a number of infertile women. The drugs administered during the study were mentioned in this article. The implantation and ongoing pregnancy rates for the women who attained an endometrial thickness of 9 mm or more are presented, as well.

Background. Directed donations (DD) are perceived to be safer than allogeneic donations. The risk of transfusion-transmissible diseases (TTDs) in DD is described as being similar to donations from first time allogeneic donors who have a higher risk of TTDs than repeat allogeneic donors. Since 1996, The Canadian Red Cross, now the Canadian Blood Services (CBS), has provided a program for DE. This program is restricted, as DD are only permitted from parents to children under the age of 17. As the CBS is considering implementing an unrestricted policy for DD, this study was conducted to ascertain the frequency of TTDs in DD. Methods. Demographics for TTDs were collected from the 14 CBS centers that offer a directed donations program and were compared to national demographics for allogeneic donations. Donations positive for TTDs were identified by screening donors for the human immunodeficiency virus (HIV 1/2), hepatitis B and C viruses, human Tlymphotropic virus (HTLV I/II) and syphilis. Results. In 1999, 750,502 allogeneic donations were made of which 11.9% were first time donations and 88.1% were repeat donations. Complete demographics for DD were available for 9 CBS centers. Since the inception of the program, 2,618 donations were collected from 1,884 directed donors. Confirmed positive markers for HIV 1/ 2 or HTLV I/II have not been detected in DD (Table). The rates of hepatitis C and hepatitis B in DD were similar to first time allogeneic donations (FAD) (Table), and the rate of hepatitis C was significantly higher in DD compared to repeat allogeneic donations (RAD). A statistically significant difference in the rate of syphilis was demonstrated between DD and both FAD and RAD. (Table). Discussion. Directed donations in Canada had higher rates of hepatitis C and syphilis than donations from repeat donors. Confirmed positive syphilis markers were detected more frequently in DD than FAD. [ABSTRACT FROM AUTHOR]