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Human embryos must fully hatch from the Zona Pellucida (ZP) for implantation. Furthermore, studies show that implantation rates increase when the embryo has low energy expenditure. Extended culture of embryos to the blastocyst stage does not allow the natural process of hatching to occur, thus necessitating assisted hatching (AH) to breach the ZP for optimal embryo development. This AH is generally performed on day 3 of culture, however this necessitates interrupting any continuous culture of embryos during incubation from day 1 to 7, especially during Time-Lapse. We set out to determine if human blastocysts possess the ability to reach the hatching stage during 5+ days of continuous culture after laser AH is performed two days earlier than standard; at the Day 1 fertilization check. A retrospective data analysis at a single large private fertility center to analyze blastocyst laser hatching performed on Day 1 when embryos undergo 5+ days of continuous culture in a Time-Lapse incubator. Oocytes were retrieved and inseminated using standard clinical practice protocols. 16-18 hours post insemination, the day 1 fertilization check was performed. Embryos with abnormal fertilization (3PN and MPN) were donated for research and underwent AH using a Hamilton Thorne Lykos Laser at a Pulse setting of 290µs per our protocol. The laser hatched embryos were placed into a Time-Lapse Embryoscope in order to monitor their ability to form blastocysts and to undergo hatching. A total of 41 abnormally fertilized embryos were cultured for 5+ days, with only 12 embryos undergoing blastulation, which is an expected rate for abnormal embryo development. All 12 embryos that formed blastocysts, hatched successfully (100%). Initial hatching was observed as early as 95 hours post insemination (3.96 days of culture) and the latest observed at 140 hours (5.83 days) with a mean time to start hatching of 112.31 hours (4.68 days). This study demonstrates that laser AH performed on day 1 at the fertilization check can produce hatching blastocysts at the expected rate. This allows practices to place embryos into Time-Lapse incubation with completely uninterrupted continuous culture for 5+ days, until the desired hatching blastocyst stage has been achieved. None None [ABSTRACT FROM AUTHOR]

Objective: To describe the results after colpourethropexy with a REMEEX prosthesis in the treatment of stress urinary incontinence with associated genital prolapse. Materials and methods: A prospective analysis of all patients treated in our Urogynaecology Unit between November 2000 and March 2001. Results: There were 29 patients with mean age of 62 and mean body mass index of 28. All but one patients had stress incontinence (genuine or mixed) associated with a genital prolapse. The other patient was a failed past technique (Marshall–Burch). Cystometry was performed in 80% of the patients. Of these 93% had genuine stress incontinence and 7% mixed incontinence. The average operating time was 119 min (CI: 60–310), and the mean hospital stay 5 days (CI: 3–13). There was one case of severe haemorrhage during surgery, four cases of wall seroma and one postoperative urinary infection. Concerning patient satisfaction, 90% of our patients felt they were cured, 8% were much better and 2% had a slight improvement. No patient had a worsening of symptoms after surgery. Conclusion: We propose colpourethropexy by suburethral sling with a REMEEX prosthesis as suitable treatment for stress incontinence with associated genital prolapse. [Copyright &y& Elsevier]

PGT-A with Next Generation Sequencing (NGS) is becoming the standard of care, and the number of blastocysts biopsied is increasing. However, there are a small percentage of blastocysts where a result is not obtained from the initial genetic analysis. The immediate desire is to often proceed with reanalysis by warming/rebiopsy/revitrification (WrBrV) for repeat PGT-A analysis. We investigated the efficacy of subjecting previously biopsied blastocysts to WrBrV in a second attempt to obtain genetic results. To determine whether it is laboratory efficient to attempt WrBrV in order to obtain a PGT-A result from a previously biopsied blastocysts. Previously biopsied and vitrified blastocysts were warmed using our standard protocol (Irvine Scientific Thaw). Assessment of blastocoel cavity expansion was performed ∼2 hours post warming; followed by trophectoderm rebiopsy, where an additional 3-5 cells were excised. The biopsied cells were placed in PCR tubes for analysis and the blastocysts were immediately revitrified. From January 2018 through February 2019, PGT-A was performed on trophectoderm cells from 2715 embryos. A 'No result' was obtained from 33 embryos (1.2%); and all were Good and Fair quality Hatching Blastocyst (HB-G, n=5; HB-F, n=28). Physicians ordered WrBrV for only 12 blastocysts (36%). Two embryos degenerated following warming and were not rebiopsied (17%). The remaining 10 blastocysts underwent biopsy and genetic results were obtained from all. Only two blastocysts were diagnosed as euploid (20%); and a Frozen Embryo Transfer (FET) was performed with a single euploid blastocyst, but resulted in a failed implantation. At our center, FETs performed with single euploid blastocysts result in a 69% pregnancy rate. This demonstrates that the biopsy, vitrification and warming techniques as performed by the embryologists at our center do not significantly diminish the potential of euploid embryos to implant. Following an initial PGT-A with no NGS result (1.2%), the process of WrBrV in our laboratory has resulted in an 83% survival rate; however only 20% of embryos have been euploid and 0% have implanted following FET, demonstrating the clinical significance and laboratory efficiency is extremely low. This study, although small in size and in need of further investigation, supports that embryos with no initial NGS result, although of good/fair quality and available for WrBrV, have a very high incidence of aneuploidy and may not warrant additional laboratory resources and reanalysis; especially when other euploid embryos are available. [ABSTRACT FROM AUTHOR]

Introduction L’atteinte hypothalamo-hypophysaire (HH) au cours de la sarcoïdose est rare, inférieure à 1 %, et peu décrite. L’infiltration granulomateuse peut entraîner des insuffisances antéhypophysaires, une hyperprolactinémie de déconnection et un diabète insipide. L’objectif de notre travail était de mieux décrire les atteintes HH au cours de la sarcoïdose, afin d’améliorer le diagnostic et la prise en charge. Patients et méthodes Une étude multicentrique rétrospective a permis d’inclure 32 patients avec une sarcoïdose systémique avec atteinte HH, diagnostiqués entre 1991 et 2016. Nous avons réalisé une analyse descriptive des données cliniques, biologiques, hormonales et radiologiques. Résultats Parmi les 32 patients inclus, il y avait 18 femmes et 14 hommes. L’âge moyen au diagnostic de sarcoïdose HH était de 40,5 ans (± 13,4). La majorité des patients ( n = 29) présentaient des symptômes compatibles avec un dysfonctionnement hormonal : asthénie ( n = 19), aménorrhée ( n = 12/14 femmes en âge de procréer), dysfonction érectile et/ou diminution de la libido ( n = 10/14 hommes). Trente et un patients avaient une insuffisance antéhypophysaire : 25 déficits gonadotropes (78 %), 20 déficits thyréotropes (65 %), 11 déficits somatotropes (46 %) et 2 déficits corticotropes. Presque la moitié des patients ( n = 15) avait un diabète insipide, dont 1 seul cas d’hypernatrémie à 149 mmol/L. Une hyperprolactiémie a été mesurée chez 24 patients (77 %). Un syndrome hypothalamique a été retrouvé chez 6 patients (19 %), caractérisé par une prise de poids massive en quelques mois (médiane 22 kg). Des anomalies radiologiques étaient quasi constantes sur l’IRM ( n = 31) : épaississement focal ou diffus de la tige pituitaire ( n = 20), infiltration de l’hypothalamus ou du plancher du 3 e ventricule ( n = 17), anomalies hypophysaires ( n = 11). Tous les patients avaient une sarcoïdose multisystémique avec comme localisations principales : ganglionnaire ( n = 24), pulmonaire ( n = 23) et neurologique ( n = 18), dont 5 patients asymptomatiques avec des anomalies IRM isolées. Les atteintes ORL étaient fréquentes avec une localisation naso-sinusienne pour 10 patients (31 %) et 9 cas de parotidites (28 %). L’enzyme de conversion était augmentée dans 68 % des cas ( n = 19/28) et 3 patients avaient une hypercalcémie. Le diagnostic histologique de sarcoïdose a été établi pour 26 patients. La quasi-totalité des patients a été traitée par corticothérapie ( n = 29), le plus souvent en association avec un autre immunosuppresseur ( n = 20) : méthotrexate ( n = 11), infliximab ( n = 7) ou mycophénolate mofétil ( n = 5). La durée moyenne de suivi était de 10 ans (± 7,5). Parmi les patients recontrôlés sur le plan hormonal : 11 avaient une prolactine normalisée (58 %), 8 avaient récupéré une fonction gonadotrope (30 %) et 1 seul avait récupéré sa fonction thyréotrope. Aucune guérison de diabète insipide n’a été rapportée. Seuls 10 patients (31 %) étaient considérés en rémission de leur sarcoïdose à la fin du suivi. Conclusion Les déficits gonadotrope, thyréotrope et l’hyperprolactinémie sont les atteintes les plus fréquentes dans notre étude réalisée sur la plus grande cohorte de sarcoïdose HH. Une récupération de la fonction gonadotrope a été observée dans 30 % des cas après traitement. La moitié des cas présente un diabète insipide définitif. Les patients avec atteinte HH ont tous une sarcoïdose multisystémique, et il semblerait que les localisations naso-sinusiennes et parotidiennes soient plus fréquentes. [ABSTRACT FROM AUTHOR]

Objective: In response to previously published findings of methylphenidate-induced chromosomal changes in children, this study was designed to determine whether methylphenidate- or amphetamine-based drugs induce chromosomal damage (structural aberrations, micronuclei, and sister chromatid exchanges) in peripheral blood lymphocytes of children with attention-deficit/hyperactivity disorder after 3 months of continuous treatment.Method: Stimulant drug-naïve subjects, 6 to 12 years of age, in good overall health, and judged to be appropriate candidates for stimulant therapy based on rigorously diagnosed ADHD using DSM-IV criteria, were randomized into two open-label treatment groups (methylphenidate or mixed amphetamine salts). Each subject provided a blood sample before initiation of treatment and after 3 months of treatment. Pretreatment and posttreatment frequencies of chromosomal aberrations, micronuclei, and sister chromatid exchanges were determined for each subject.Results: Sixty-three subjects enrolled in the study; 47 subjects completed the full 3 months of treatment, 25 in the methylphenidate group and 22 in the amphetamine group. No significant treatment-related increases were observed in any of the three measures of cytogenetic damage in the 47 subjects who completed treatment or the 16 subjects who did not.Conclusions: Earlier findings of methylphenidate-induced chromosomal changes in children were not replicated in this study. These results add to the accumulating evidence that therapeutic levels of methylphenidate do not induce cytogenetic damage in humans. Furthermore, our results indicate that amphetamine-based products do not pose a risk for cytogenetic damage in children. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To determine how serum concentrations of resistin are distributed in humans in relation to insulin resistance, type 2 diabetes, and obesity. Methods: Cross-sectional, descriptive study carried out in a random sample (n =713, 43% men, 18–75 years) of general population of inhabitants of the Canary Islands (Spain). Serum resistin concentration, HOMA2-IR, anthropometric parameters, drug consumption and physical activity were recorded. Results: There were no differences in resistin concentration between participants with and without diabetes (3.1±0.2 vs. 3.2±0.1ng/mL; p =0.566), or between obese and non-obese participants (3.1±0.1 vs. 3.2±0.1ng/mL; p =0.803). Individuals with abdominal obesity (waist-hip ratio [WHR] ≥1 in men or ≥0.9 in women) had lower concentrations of resistin (3.0±0.13 vs. 3.4±0.1ng/mL; p <0.001). The correlations between resistin and HOMA2-IR (r =−0.231; p <0.001) and between resistin and WHR (r =−0.202; p <0.001) were inverse. Multivariate analysis corroborated the inverse association of this cytokine with HOMA2-IR, WHR and, in women, also retained in the model the direct association between resistin and physical activity and the inverse association between resistin and antihypertensive agents. Conclusions: In this population resistin is inversely associated with insulin resistance and abdominal obesity. [Copyright &y& Elsevier]