1
|
Cote C, de Waard D, Tansley G, Horne G, Hassan A, Hajizadeh M, Herman C. INCREASED TRAVEL TIME TO THE TERTIARY CENTRE IS ASSOCIATED WITH DECREASED LONG-TERM SURVIVAL FOLLOWING ASCENDING AORTIC OPERATIONS. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
2
|
Adeniyi T, Horne G, Ruane PT, Brison DR, Roberts SA. Clinical efficacy of hyaluronate-containing embryo transfer medium in IVF/ICSI treatment cycles: a cohort study. Hum Reprod Open 2021; 2021:hoab004. [PMID: 33718621 PMCID: PMC7937422 DOI: 10.1093/hropen/hoab004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/19/2020] [Indexed: 12/29/2022] Open
Abstract
STUDY QUESTION Does the duration of embryo exposure to hyaluronic acid (HA) enriched medium improve the rate of live birth events (LBEs)? SUMMARY ANSWER The use of embryo transfer (ET) medium rich in HA improves LBE (a singleton or twin live birth) regardless of the duration of exposure evaluated in this study, but does not alter gestation or birthweight (BW). WHAT IS KNOWN ALREADY HA-enriched medium is routinely used for ET in ART to facilitate implantation, despite inconclusive evidence on safety and efficacy. STUDY DESIGN SIZE DURATION A cohort study was performed evaluating clinical treatment outcomes before and after HA-enriched ET medium was introduced into routine clinical practice. In total, 3391 fresh ET procedures were performed using low HA and HA-rich medium in women undergoing publicly funded IVF/ICSI treatment cycles between May 2011 and April 2015 were included in this cohort study. PARTICIPANTS/MATERIALS SETTING METHODS A total of 1018 ET performed using low HA medium were compared with 1198, and 1175 ET following exposure to HA-rich medium for 2-4 h (long HA exposure) or for 10-30 min (short HA exposure), respectively. A multiple logistic regression analysis was used to compare clinical outcomes including BW, gestational age and sex ratios between groups, whilst adjusting for patient age, previous attempt, incubator type and the number of embryos transferred. MAIN RESULTS AND THE ROLE OF CHANCE The use of HA-rich medium for ET was positively and significantly associated with improved clinical pregnancy rate and LBE, for both exposure durations: long HA (odds ratio (OR) = 1.21, 95% CI: 0.99-1.48), short HA (OR = 1.32, 95% CI: 1.02-1.72) and pooled OR = 1.26, 95% CI: 1.03-1.54, relative to the use of low HA medium. A comparative analysis of the risks of early pregnancy loss following long HA exposure (OR = 0.76, 95% CI: 0.54-1.06), short HA exposure (OR = 0.84, 95% CI: 0.54-1.30) and late miscarriage (OR = 0.88, 95% CI: 0.51-1.53) (OR = 1.41, 95% CI 0.72-2.77), were lower and not statistically significant. Similarly, ordinary regression analysis of the differences in BW at both HA exposures; pooled OR = -0.9 (-117.1 to 115.3), and adjusted BW between both HA cohorts; pooled OR = -13.8 (-106.1 to 78.6) did not show any differences. However, a difference in gestational age (pooled OR -0.3 (-3.4 to 2.9)) and sex ratio (pooled OR 1.43 (0.95-2.15)) were observed but these were not statistically significant relative to low HA medium. LIMITATIONS REASONS FOR CAUTION The strength of a randomized treatment allocation was not available in this evaluation study, therefore effects of unmeasured or unknown confounding variables cannot be ruled out. WIDER IMPLICATIONS OF THE FINDINGS The result of this large cohort study strengthens the case for using HA-rich medium routinely at transfer, while adding the important clinical information that duration of exposure may not be critical. The composition and effects of commercial IVF culture media on success rate and safety remains a major controversy despite increasing calls for transparency and evidence-based practice in ART. Nonetheless, the lack of differences in BW and gestational age observed in this study were reassuring. However, an appraisal of clinical outcomes and appropriate research investigations are required for the continuous evaluation of efficacy and safety of HA. STUDY FUNDING/COMPETING INTERESTS T.A. is funded by a Clinical Doctoral Research Fellowship (CDRF) grant (reference: ICA-CDRF-2015-01-068) from the National Institute for Health Research (NIHR). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. The authors declare no conflict of interest.
Collapse
Affiliation(s)
- Tope Adeniyi
- Department of Reproductive Medicine, Old Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Old Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Peter T Ruane
- Maternal and Fetal Health Research Centre, Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, Old Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Developmental Biology and Medicine, Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Stephen A Roberts
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
3
|
Castillo CM, Horne G, Fitzgerald CT, Johnstone ED, Brison DR, Roberts SA. The impact of IVF on birthweight from 1991 to 2015: a cross-sectional study. Hum Reprod 2020; 34:920-931. [PMID: 30868153 DOI: 10.1093/humrep/dez025] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION Has birthweight (BW) changed over time among IVF-conceived singletons? SUMMARY ANSWER Singleton BW has increased markedly over the past 25 years. WHAT IS KNOWN ALREADY IVF conceived singletons have had a higher incidence of low BW compared to spontaneously conceived singletons, and this has raised concerns over long-term increased risks of cardio-metabolic disease. However, few causal links between IVF procedures and BW have been robustly established, and few studies have examined whether BW has changed over time as IVF techniques have developed. STUDY DESIGN, SIZE, DURATION A total of 2780 live born singletons conceived via IVF or ICSI treated in the reproductive medicine department of a single publicly funded tertiary care centre between 1991 and 2015 were included in this retrospective study. The primary outcome measure was singleton BW adjusted for gestational age, maternal parity and child gender. Multivariable linear regression models were used to estimate the associations between patient prognostic factors and IVF treatment procedures with adjusted BW. PARTICIPANTS/MATERIALS, SETTING, METHODS All singletons conceived at the centre following IVF/ICSI using the mother's own oocytes, and non-donated fresh or frozen/thawed embryos with complete electronic data records, were investigated. Available electronic records were retrieved from the Human Fertilization and Embryology Authority for dataset collation. Multiple linear regression analysis was used to evaluate associations between IVF treatment parameters and BW, after adjusting for the year of treatment and patient characteristics and pregnancy factors. MAIN RESULTS AND THE ROLE OF CHANCE In the primary multivariable model, singleton BW increased by 7.4 g per year (95% CI: 3.2-11.6 g, P = 0.001), an increase of close to 180 g throughout the 25-year period after accounting for gestational age, maternal parity, child gender, IVF treatment parameters, patient prognostic characteristics and pregnancy factors. Fresh and frozen embryo transfer-conceived singletons showed a similar increase in BW. Frozen/thawed embryo transfer conceived singletons were on average 53 g heavier than their fresh embryo conceived counterparts (95% CI: 3.7-103.3 g, P = 0.035). LIMITATIONS, REASONS FOR CAUTION The independent variables included in the study were limited to those that have been consistently recorded and stored electronically over the past two decades. WIDER IMPLICATIONS OF THE FINDINGS There has been a progressive BW increase in IVF singletons over time in one large centre with consistent treatment eligibility criteria. Such a change is not seen in the general population of live born singletons in the UK or other developed countries, and seems to be specific to this IVF population. This may be a reflection of changes in practice such as undisturbed extended embryo culture to the blastocyst stage, optimized commercial culture media composition, single embryo transfer and ICSI. Moreover, singletons conceived from frozen/thawed embryos had higher birth weights when compared to their fresh embryo transfer counterparts. The causal pathway is unknown; however, it could be due to the impact on embryos of the freeze/thaw process, self-selection of embryos from couples who produce a surplus of embryos, and/or embryo replacement into a more receptive maternal environment. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the EU FP7 project grant, EpiHealthNet (FP7-PEOPLE-2012-ITN-317146). The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Catherine M Castillo
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Cheryl T Fitzgerald
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Edward D Johnstone
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Daniel R Brison
- Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Maternal & Fetal Health Research Centre, St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK.,Department of Reproductive Medicine, Old St. Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Rd., Manchester, UK
| | - Stephen A Roberts
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Oxford Rd., Manchester, UK
| |
Collapse
|
4
|
Kalleas D, McEvoy K, Horne G, Roberts SA, Brison DR. Live birth rate following undisturbed embryo culture at low oxygen in a time-lapse incubator compared to a high-quality benchtop incubator. HUM FERTIL 2020; 25:147-153. [PMID: 32098536 DOI: 10.1080/14647273.2020.1729423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Time-lapse (TL) incubators are increasingly used in in vitro fertilization (IVF) laboratories but there have been few studies of their effectiveness in comparison to other incubator types. Moreover, the design of most studies has been limited by the quality of the control incubator. We have therefore performed a one-year pseudo-randomized prospective study of IVF cycles using a TL incubator (EmbryoScope™) (n = 243) or a conventional incubator (K-System G-185 Flatbed) (n = 203). The two groups were well matched in terms of clinical parameters: IVF cycle attempt number, IVF/ICSI, age, number and day (3 or 5) of embryo transfer. Embryos were selected for transfer using conventional (non-TL) morphological grading. The EmbryoScope group had an increased chance of a live birth (43.2% vs. 34.5%; OR = 1.43 [95%CI: 0.96-2.13]) with significantly reduced early pregnancy loss (5.8% vs. 13.8%; OR = 0.37 [0.19-0.74]) compared to the K-System incubator. There was a higher proportion of 4-cell embryos on day 2 and 8-cell embryos on day 3 in the EmbryoScope, compared to the K-Systems. The use of TL incubators is appropriate in ART by virtue of their high specification, facility for low oxygen culture and provision of minimally disturbed culture conditions which limit exposure of human embryos to environmental stress.
Collapse
Affiliation(s)
- Dimitrios Kalleas
- Department of Reproductive Medicine, Old St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Keith McEvoy
- Department of Reproductive Medicine, Old St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Old St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Stephen A Roberts
- Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, Old St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.,Maternal & Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| |
Collapse
|
5
|
Berneau SC, Shackleton J, Nevin C, Altakroni B, Papadopoulos G, Horne G, Brison DR, Murgatroyd C, Povey AC, Carroll M. Associations of sperm telomere length with semen parameters, clinical outcomes and lifestyle factors in human normozoospermic samples. Andrology 2019; 8:583-593. [PMID: 31769603 DOI: 10.1111/andr.12734] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/21/2019] [Accepted: 11/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Many studies have demonstrated that lifestyle factors can affect sperm quality and fertility. Sperm telomere length (STL) has been reported as potential biomarker or sperm quality. However, no studies have investigated how lifestyle factors can affect STL and associated clinical outcomes. OBJECTIVES The purpose of this manuscript is to investigate any association between STL with lifestyle factors, semen parameters and clinical outcomes. MATERIALS AND METHODS Sperm telomere length was measured using real-time PCR in normozoospermic male partners (n = 66) of couples undergoing ART treatment. Each participant also completed a detailed questionnaire about general lifestyle. Linear regression univariate analysis and ANCOVA were performed to respectively determine correlations between STL and study parameters or identify statistically significant differences in STL while controlling for age, BMI and other factors. RESULTS Using a linear regression model, STL is positively correlated with in vitro fertilization success (n = 65, r = 0.37, P = .004) but not with embryo cleavage rates and post-implantation clinical outcomes including gestational age-adjusted birth weight. No associations were observed between STL and sperm count, concentration or progressive motility. We further found that STL did not associate age, BMI, health or lifestyle factors. DISCUSSION In somatic cells, the rate of telomere shortening is influenced by a number of lifestyle factors such as smoking, diet and occupation. However, little is known about how lifestyle factors affect STL and subsequently reproductive outcome. Out data suggest that STL might have an important role mechanistically for fertilization rate regardless of sperm parameters and lifestyle factors. CONCLUSION The results of this study demonstrate that STL is associated with in vitro fertilization rates, but not with semen parameters nor lifestyle factors. Further investigations are warranted to identify the potential variation of STL overtime to clarify its significance as a potential biomarker in ART.
Collapse
Affiliation(s)
- Stephane C Berneau
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Jennifer Shackleton
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Clare Nevin
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Basher Altakroni
- Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - George Papadopoulos
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.,Maternal and Fetal Health Research Centre, Division of Developmental Biology & Medicine, School of Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Christopher Murgatroyd
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Andy C Povey
- Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Michael Carroll
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
6
|
Nickkho-Amiry M, Horne G, Akhtar M, Mathur R, Brison DR. Hydatidiform molar pregnancy following assisted reproduction. J Assist Reprod Genet 2019; 36:667-671. [PMID: 30612209 DOI: 10.1007/s10815-018-1389-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION The use of assisted reproduction techniques (ART) is increasing; however, reports of molar pregnancy following ART remain scarce. Currently, the Human Fertility and Embryology Authority (HFEA) collates data on the molar pregnancies that have resulted through the use of ART. Recently, they have indicated that they will no longer collect these data. AIM This paper aimed to examine the incidence of molar pregnancy amongst patients undergoing assisted reproduction. METHODS We contacted HFEA and placed a request under the Freedom of Information Act (2000) for the number of molar pregnancies that resulted from fresh/frozen embryo transfer since HFEA started collecting data in 1991 to February 2018. We also asked how many patients who had suffered a molar pregnancy went on to have a normal pregnancy and how many had subsequent molar pregnancies, in subsequent treatment cycles. RESULTS Between 68 and 76 molar pregnancies occurred within this period using ART (n = 274,655). The incidence of molar pregnancy using fresh intracytoplasmic sperm injection (ICSI) (1/4302) and fresh in vitro fertilisation (IVF) (1/4333) was similar. The risk of recurrence of molar pregnancy following a previous molar was higher following ART compared to spontaneous conceptions. CONCLUSION The use of ICSI should be protective against triploidy; however, the retrospective data suggests that molar pregnancy is not eliminated with the use of ART. It is pertinent to continue to record this data, through the gestational trophoblastic disease centres, in order to ensure no further increase in incidence, appropriate follow-up, and transparency in communication.
Collapse
Affiliation(s)
- M Nickkho-Amiry
- Department of Obstetrics and Gynaecology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-lyne, OL6 9RW, UK.
| | - G Horne
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - M Akhtar
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - R Mathur
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - D R Brison
- Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.,Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| |
Collapse
|
7
|
Affiliation(s)
- Yazan Abdallah
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester, UK
| | - Jonathan Briggs
- School of Medicine, University of Manchester, Manchester, UK
| | - Joshua Jones
- Homerton University Hospital, Homerton Row, London, UK
| | - Gregory Horne
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester, UK
| | - Cheryl Fitzgerald
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester, UK
| |
Collapse
|
8
|
Medlicott SAC, Coderre S, Horne G, Panaccione R. Multimodal Immunosuppressant Therapy in Steroid-Refractory Common Variable Immunodeficiency Sprue: A Case Report Complicating Cytomegalovirus Infection. Int J Surg Pathol 2016; 14:101-6. [PMID: 16501846 DOI: 10.1177/106689690601400120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Immunodeficient patients can develop malabsorption, mimicking celiac disease clinically and histologically. Such individuals may also occasionally require immunosup pressive therapy for autoimmune disorders. We have identified a patient with common variable immunodeficiency (CVID)-associated sprue complicated by duodenal cytomegalovirus (CMV) infection following corticosteroid and ancillary immunomodulatory therapy. Ganciclovir and a modification of the immunosuppressant regimen improved both clinical symptoms and villous atrophy. To our knowledge, this is original documentation of duodenal CMV infection secondary to immunomodulatory therapy for steroid-refractory CVID-sprue.
Collapse
Affiliation(s)
- S A C Medlicott
- Department of Laboratory Medicine, Peter Lougheed Centre, University of Calgary, Canada
| | | | | | | |
Collapse
|
9
|
Brison DR, Hooper M, Critchlow JD, Hunter HR, Arnesen R, Lloyd A, Horne G. Reducing risk in the IVF laboratory: implementation of a double witnessing system. ACTA ACUST UNITED AC 2016. [DOI: 10.1258/1356262041591131] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
10
|
Cerra C, Newman WG, Tohlob D, Byers H, Horne G, Roberts SA, Mohiyiddeen L. AMH type II receptor and AMH gene polymorphisms are not associated with ovarian reserve, response, or outcomes in ovarian stimulation. J Assist Reprod Genet 2016; 33:1085-91. [PMID: 27142041 PMCID: PMC4974219 DOI: 10.1007/s10815-016-0711-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 03/28/2016] [Indexed: 01/27/2023] Open
Abstract
Purpose Genetic variation may influence women’s response to ovarian stimulation therapy. The purpose of this study was to investigate any effects of genetic variants in the anti-Müllerian hormone (AMH) and AMH type II receptor genes on ovarian response/treatment outcomes and on current markers of ovarian reserve in individuals undergoing in vitro fertilisation (IVF) treatment. Methods In this prospective observational study, we genotyped the AMH c.146G>T, p.(Ile49Ser) and AMHR2 -482A>G variants in 603 unrelated women undergoing their first cycle of controlled ovarian stimulation for IVF and ICSI (intracytoplasmic sperm injection) using gonadotrophins at a tertiary referral centre for reproductive medicine. Pelvic ultrasound and blood hormone levels were taken on days 2–3 of the cycle. Genotypes were determined using TaqMan allelic discrimination assay. Regression analysis was performed to assess the relationship between the genotypes and the ovarian reserve markers (FSH, AMH, antral follicle count) and the early outcomes of response (number of oocytes retrieved and gonadotropin dose) as well as the treatment outcome (live birth). Results There were no significant associations between the variants AMH c.146G>T and AMHR2 -482A>G with ovarian response in terms of number of oocytes retrieved (p = 0.08 and p = 0.64, respectively), live births (p = 0.28 and p = 0.52) and/or markers of ovarian reserve. Conclusions Genotyping of the AMH c.146G>T and AMHR2 -482A>G polymorphisms does not provide additional useful information as a predictor of ovarian reserve or ovarian response and treatment outcomes.
Collapse
Affiliation(s)
- Christian Cerra
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK.,Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, M13 9WL, UK
| | - William G Newman
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, M13 9WL, UK.,Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Dalia Tohlob
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, M13 9WL, UK.,Clinical pathology, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Helen Byers
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, M13 9WL, UK.,Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Gregory Horne
- Clinical Embryology, Department of Reproductive Medicine, St. Mary's Hospital, Manchester, UK
| | - Stephen A Roberts
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK.,Centre for Biostatistics, Institute of Population Health, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, UK
| | - Lamiya Mohiyiddeen
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK.
| |
Collapse
|
11
|
Balcerzyk A, Schmidhammer U, Horne G, Wang F, Ma J, Pimblott SM, de la Lande A, Mostafavi M. Unexpected Ultrafast Silver Ion Reduction: Dynamics Driven by the Solvent Structure. J Phys Chem B 2015; 119:10096-101. [DOI: 10.1021/acs.jpcb.5b04907] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anna Balcerzyk
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| | - Uli Schmidhammer
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| | - Gregory Horne
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
- Dalton
Cumbrian Facility, The University of Manchester, Westlakes Science and Technology
Park, Moor Row, Cumbria, CA24 3HA, United Kingdom
- School
of Chemistry, The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Furong Wang
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| | - Jun Ma
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| | - Simon M. Pimblott
- Dalton
Cumbrian Facility, The University of Manchester, Westlakes Science and Technology
Park, Moor Row, Cumbria, CA24 3HA, United Kingdom
- School
of Chemistry, The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Aurélien de la Lande
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| | - Mehran Mostafavi
- Laboratoire
de Chimie Physique, CNRS/Université Paris-Sud, Bâtiment
349, 91405 Orsay, France
| |
Collapse
|
12
|
Cerra C, Oliver J, Roberts SA, Horne G, Newman WG, Mohiyiddeen L. A single nucleotide polymorphism of bone morphogenic protein-15 is not associated with ovarian reserve or response to ovarian stimulation. Hum Reprod 2014; 29:2832-7. [PMID: 25336710 DOI: 10.1093/humrep/deu264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is there any effect of the -9C>G variant in the bone morphogenic protein-15 (BMP15) gene on ovarian response and/or current markers of ovarian reserve in patients undergoing in vitro fertilization (IVF) treatment? SUMMARY ANSWER No significant associations of BMP15 genotypes with ovarian response (number of oocytes retrieved) and/or markers of ovarian reserve were detected in our cohort of women undergoing IVF treatment. WHAT IS KNOWN ALREADY There is evidence that genetic variation influences patients' response to ovarian stimulation therapy. BMP15 plays a role in the recruitment of primordial follicles. Therefore, variation in BMP15 could predict ovarian reserve and response to ovarian stimulation. Two previous studies have determined a significant correlation between the BMP15 -9C>G variant and over-response to ovarian stimulation. No studies to date have correlated this variant with ovarian reserve markers. STUDY DESIGN, SIZE, DURATION In this prospective observational study, we genotyped the BMP15 -9C>G single nucleotide polymorphism in 239 unrelated women undergoing their first cycle of controlled ovarian stimulation for IVF and ICSI (intra-cytoplasmic sperm injection) using gonadotrophins at a tertiary referral centre for reproductive medicine between March 2009 and August 2010. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Baseline pelvic ultrasound and blood tests were taken on Days 2-3 of the cycle for assessment of baseline hormones and for DNA extraction. Genotypes were determined using TaqMan allelic discrimination assay. Regression analysis was performed to assess the effect of the BMP15 genotype on the ovarian reserve markers, serum anti-Müllerian hormone (s-AMH), follicle stimulating hormone (s-FSH) and antral follicle count (AFC), with adjustment for age and body mass index (BMI), and on the primary outcomes of response (number of oocytes retrieved and gonadotrophin dose) with adjustment for age, BMI and treatment received. MAIN RESULTS AND THE ROLE OF CHANCE There was no evidence of any statistically significant (P < 0.05) difference in basal s-FSH, s-AMH and AFC between individuals with different BMP15 genotypes. The number of oocytes retrieved and gonadotrophin dose used were also comparable between the individuals with different genotypes. LIMITATIONS, REASONS FOR CAUTION A larger sample size would be required in order to determine if the BMP15 genotype has a small effect on ovarian reserve or response. WIDER IMPLICATIONS OF THE FINDINGS When considering the development of integrative clinical algorithms for individual FSH doses, our analysis suggests that the genotyping of BMP15 -9C>G does not provide additional useful information as a predictor of ovarian reserve or response to ovarian stimulation. STUDY FUNDING/COMPETING INTERESTS The study was funded by the Manchester Biomedical Research Centre. The authors have no competing interests to declare.
Collapse
Affiliation(s)
- Christian Cerra
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK
| | - Jonathan Oliver
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK
| | - Stephen A Roberts
- Centre for Biostatistics, Institute of Population Health, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, UK
| | - Gregory Horne
- Clinical Embryology, Department of Reproductive Medicine, St. Mary's Hospital, Manchester, UK
| | - William G Newman
- Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Lamiya Mohiyiddeen
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| |
Collapse
|
13
|
Tinsley J, Janghra N, Wilson F, Sewry C, Horne G, Morgan J. G.P.103. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Muntoni F, Spinty S, Roper H, Hughes I, Ricotti V, Bracchi A, Horne G, Tinsley J. G.P.102. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
15
|
Fairclough R, Guiraud S, Squire S, Babbs A, Edward B, Shah N, Bracchi A, Wilson F, Horne G, Robinson N, Araujo N, Hewings D, Vuorinen A, Davies S, Wynne G, Russell A, Tinsley J, Davies K. G.P.89. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
16
|
Herman C, Launcelott S, El-Khateeb O, Wood J, Horne G. Identifying Dilated Aortic Root Diameters in Nova Scotia; Is a Screening Program Warranted? Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
17
|
Tinsley J, Robinson N, Wilson F, Horne G, Fairclough R, Davies K. P.13.14 Future clinical and biomarker development for SMTC1100, the first utrophin modulator to enter clinical trials for Duchenne Muscular Dystrophy (DMD). Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
18
|
Abstract
Hypersensitivity to human semen (HHS) is an increasingly reported condition with symptoms manifested locally and systemically, which in some cases may result in anaphylaxis. This report describes four cases of HHS all with positive allergy skin prick tests to partner's whole semen. None of the patients elicited a response to seminal fluid-free washed spermatozoa. In cases of high risk of anaphylaxis, we recommend avoiding exposure to semen. By carrying out an allergy skin prick test on seminal fluid-free washed spermatozoa, the risk of immunogenic reaction to the spermatozoa could be eliminated.
Collapse
Affiliation(s)
- Michael Carroll
- Department of Reproductive Medicine, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK.
| | | | | | | | | | | |
Collapse
|
19
|
|
20
|
Horne G, Biggs J. Gaining 'real-time' feedback to influence patient and family care. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000100.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
21
|
|
22
|
Willenbockel V, Sadr J, Fiset D, Horne G, Gosselin F, Tanaka J. The SHINE toolbox for controlling low-level image properties. J Vis 2010. [DOI: 10.1167/10.7.653] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
23
|
Blair A, Daynes N, Hamilton D, Horne G, Heard PJ, Hodgson DZL, Scott TB, Shterenlikht A. Residual stress relaxation measurements across interfaces at macro-and micro-scales using slitting and DIC. ACTA ACUST UNITED AC 2009. [DOI: 10.1088/1742-6596/181/1/012078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
24
|
Ali CR, Khashan AS, Horne G, Fitzgerald CT, Nardo LG. Implantation, clinical pregnancy and miscarriage rates after introduction of ultrasound-guided embryo transfer. Reprod Biomed Online 2008; 17:88-93. [DOI: 10.1016/s1472-6483(10)60298-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Dawson J, Vig S, Choke E, Blundell J, Horne G, Downham C, Loftus I, Thompson M. Medical Optimisation Can Reduce Morbidity and Mortality Associated with Elective Aortic Aneurysm Repair. J Vasc Surg 2007. [DOI: 10.1016/j.jvs.2006.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
26
|
Dawson J, Vig S, Choke E, Blundell J, Horne G, Downham C, Loftus I, Thompson MM. Medical Optimisation Can Reduce Morbidity and Mortality Associated with Elective Aortic Aneurysm Repair. Eur J Vasc Endovasc Surg 2007; 33:100-4. [PMID: 17027302 DOI: 10.1016/j.ejvs.2006.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2006] [Accepted: 08/06/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Patients with aortic aneurysms have significant comorbidities which influence outcome. Our practice includes comprehensive assessment to identify comorbidities, allowing subsequent medical optimisation prior to aneurysm repair. The aim of this study was to assess this process and to identify any factors predictive of outcome. DESIGN Prospective observational study. MATERIALS Medical case notes of 200 patients referred with aortic pathology. METHODS Data analysed included preoperative, perioperative and postoperative factors. Multiple logistic regression analysis was performed to identify predictors of outcome. RESULTS Following assessment 17 patients (8.5%) were found to be unfit for intervention and 165 patients (82.5%) proceeded to aneurysm repair. In this group assessment uncovered previously undiagnosed cardiac, respiratory and renal comorbidity in 19%, 57% and 29% of patients respectively. Multiple logistic regression analysis indicated that optimisation by a renal physician reduced post-operative renal impairment (OR 0.12, 95% CI 0.03-0.45, P=0.002) while optimisation by a cardiologist reduced respiratory complications (OR 0.7, 95% CI 0.05-0.99, P=0.049). An abnormal echocardiogram was associated with pneumonia (OR 6.9, 95% CI 1.6-29, P=0.01) and death (OR 7.9, 95% CI 1.15-54, P=0.036). CONCLUSION Pre-operative assessment identifies previously undiagnosed comorbidity in a significant proportion of patients. Subsequent medical optimisation may reduce post-operative morbidity and mortality.
Collapse
Affiliation(s)
- J Dawson
- St George's Vascular Institute, London, UK
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Rubina Ali C, Nardo L, Horne G, Fitzgerald C. P-303. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.07.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Horne G, Atkinson AD, Pease EHE, Logue JP, Brison DR, Lieberman BA. Live birth with sperm cryopreserved for 21 years prior to cancer treatment: case report. Hum Reprod 2004; 19:1448-9. [PMID: 15163644 DOI: 10.1093/humrep/deh249] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Advances in cancer treatment have led to significant improvements in the likelihood of reaching remission and long-term survival for men. Chemo- and radiotherapy-induced infertility are significant treatment side effects. Cryopreservation before the start of treatment enables sperm to be stored, thereby preserving the man's potential fertility. Here, we describe the successful use (with ICSI) of sperm cryopreserved prior to cancer treatment, for a total of 21 years. We believe this to be the longest period of sperm cryopreservation, resulting in a live birth, so far reported in the literature.
Collapse
Affiliation(s)
- G Horne
- Department of Reproductive Medicine, St Mary's Hospital, Manchester M13 0JH, UK.
| | | | | | | | | | | |
Collapse
|
29
|
Horne G, Brison DR. Reply to ‘Live birth with sperm cryopreserved for 21 years’. Hum Reprod 2004. [DOI: 10.1093/humrep/deh455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
30
|
Anjum ZK, Abdo K, Horne G, Brison DR, Abdulla U, Lieberman BA. Transport of embryos resulting from intracytoplasmic sperm injection, but not oocytes, adversely affects implantation. Fertil Steril 2003; 80:1529-31. [PMID: 14667900 DOI: 10.1016/s0015-0282(03)02209-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Abstract
This study analysed the live birth rates in 760 couples referred in 1994 to St Mary's Hospital, Manchester, a non-fee-paying National Health Service (NHS) centre, who had waited for up to 4 years for IVF treatment. These live birth rates were compared with those of 199 couples referred at a similar time to Manchester Fertility Services, a fee-paying unit, where they received IVF treatment shortly after referral. The waiting time was advantageous in that 17.8% (135 of 760) of the couples referred to St Mary's Hospital conceived without IVF treatment, 60% within one year of referral. However, the waiting time was detrimental to women aged 30-34 in whom treatment was delayed by 3-4 years. Only 26.8% (204 of 760) of couples originally referred eventually received NHS-funded IVF treatment at St Mary's. A waiting time not exceeding 18 months would allow most spontaneous conceptions and reduce the adverse effect of prolonged waiting on the take-up rate for treatment and on the chance of success in the older women.
Collapse
Affiliation(s)
- Gregory Horne
- Department of Reproductive Medicine, St Mary's Hospital, Hathersage Road, Whitworth Park, Manchester M13 0JH, UK
| | | | | | | | | | | |
Collapse
|
32
|
Blackhall FH, Atkinson AD, Maaya MB, Ryder WDJ, Horne G, Brison DR, Lieberman BA, Radford JA. Semen cryopreservation, utilisation and reproductive outcome in men treated for Hodgkin's disease. Br J Cancer 2002; 87:381-4. [PMID: 12177773 PMCID: PMC2376135 DOI: 10.1038/sj.bjc.6600483] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2001] [Revised: 05/16/2002] [Accepted: 06/15/2002] [Indexed: 12/03/2022] Open
Abstract
Between 1978 and 1990, 122 men underwent semen analysis before starting sterilising chemotherapy for Hodgkin's disease. Eighty-one (66%) had semen quality within the normal range, 25 were oligospermic (<20 x 10(6) sperm per ml) and five were azoospermic (no sperm in the ejaculate). Semen from 115 men was cryopreserved and after a median follow-up time of 10.1 years, 33 men have utilised stored semen (actuarial rate 27%) and nine partners have become pregnant resulting in 11 live births and one termination for foetal malformation. Actuarial 10 year rates of destruction of semen before death or utilisation and death before utilisation are 19% and 13% respectively. This retrospective cohort study demonstrates that approximately one-quarter of men utilising cryopreserved semen after treatment for Hodgkin's disease obtain a live birth. The high non-utilisation rate is intriguing and warrants further investigation.
Collapse
Affiliation(s)
- F H Blackhall
- Cancer Research UK Department of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, UK
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
The adenophostins exhibit approximately 10-100 times higher receptor binding and Ca2+ mobilising potencies in comparison with the natural second messenger D-myo-inositol 1,4,5-trisphosphate [Ins(1,4,5)P3]. Despite many synthetic attempts to determine the minimal structural requirement for this unusual behaviour of the adenophostins, few related simplified analogues displaying higher activity than that of Ins(1,4,5)P3 have been reported. However, biological evaluation of such analogues has revealed that one of the key factors for the enhanced biological activity is the adenine moiety. To further understand the effect that the adenine base has upon the activity of the adenophostins, congeners in which this functionality is replaced by uracil, benzimidazole, 2-methoxynaphthalene, 4-methylanisole and 4-methylnaphthalene using the common intermediate 1,2-di-O-acetyl-5-O-benzyl-3-O-(3,4-di-O-acetyl-2,6-di-O-benzyl-alpha-D-glucopyranosyl)-ribofuranose have been synthesised using a base replacement strategy. The synthesis of the uracil and benzimidazole analogues was achieved using the Vorbrüggen condensation procedure. The 1'-C-glycosidic analogues were prepared using Friedel-Crafts type C-aryl glycosidation reactions. Phosphate groups were introduced using the phosphoramidite method with subsequent removal of all-benzyl protecting groups by catalytic hydrogenation or catalytic hydrogen transfer. Apart from one analogue with an alpha-glycosidic linkage all compounds were more potent than Ins(1,4,5)P3 and most tended more towards adenophostin in activity. These analogues will be valuable tools to unravel the role that the adenine moiety plays in the potent activity of the adenophostins and demonstrate that this strategy is effective at producing highly potent ligands.
Collapse
Affiliation(s)
- S Shuto
- Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, UK
| | | | | | | |
Collapse
|
34
|
Correa V, Riley AM, Shuto S, Horne G, Nerou EP, Marwood RD, Potter BV, Taylor CW. Structural determinants of adenophostin A activity at inositol trisphosphate receptors. Mol Pharmacol 2001; 59:1206-15. [PMID: 11306705 DOI: 10.1124/mol.59.5.1206] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Adenophostin A is the most potent known agonist of inositol 1,4,5-trisphosphate (InsP(3)) receptors. Ca(2+) release from permeabilized hepatocytes was 9.9 +/- 1.6-fold more sensitive to adenophostin A (EC(50), 14.7 +/- 2.4 nM) than to InsP(3) (145 +/- 10 nM), consistent with the greater affinity of adenophostin A for hepatic InsP(3) receptors (K(d) = 0.48 +/- 0.06 and 3.09 +/- 0.33 nM, respectively). Here, we systematically modify the structures of the glucose, ribose, and adenine moieties of adenophostin A and use Ca(2+) release and binding assays to define their contributions to high-affinity binding. Progressive trimming of the adenine of adenophostin A reduced potency, but it fell below that of InsP(3) only after complete removal of the adenine. Even after substantial modifications of the adenine (to uracil or even unrelated aromatic rings, retaining the beta-orientation), the analogs were more potent than InsP(3). The only analog with an alpha-ribosyl linkage had massively decreased potency. The 2'-phosphate on the ribose ring of adenophostin A was essential and optimally active when present on a five-membered ring in a position stereochemically equivalent to its location in adenophostin A. Xylo-adenophostin, where xylose replaces the glucose ring of adenophostin A, was only slightly less potent than adenophostin A, whereas manno-adenophostin (mannose replacing glucose) had similar potency to InsP(3). These results are consistent with the relatively minor role of the 3-hydroxyl of InsP(3) (the equivalent is absent from xylo-adenophostin) and greater role of the equatorial 6-hydroxyl (the equivalent is axial in manno-adenophostin). This is the first comprehensive analysis of all the key structural elements of adenophostin A, and it provides a working model for the design of related high-affinity ligands of InsP(3) receptors.
Collapse
Affiliation(s)
- V Correa
- Department of Pharmacology, University of Cambridge, Cambridge, CB2 1QJ, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Horne G, Fielden J. Hip fracture rates in South Australia: Into the next century. ANZ J Surg 2001; 71:253-4. [PMID: 11355738 DOI: 10.1046/j.1440-1622.2001.2091d.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
36
|
Fielden J, Purdie G, Horne G, Devane P. Hip fracture incidence in New Zealand, revisited. N Z Med J 2001; 114:154-6. [PMID: 11400921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
AIM Earlier predictions of the incidence of hip fractures in the older adult population suggested that by 2011 the rate would rise to epidemic proportions. The purpose of this study was to compare the number hip fractures occuring in New Zealand from 1988 to 1999 with the hip fracture rate predicted in 1990 by Rockwood, Horne and Cryer. METHODS Data on the number of patients admitted to New Zealand hospitals with a diagnosis of fractured neck of femur were obtained, and compared with weighted regression and baseline predictions of Rockwood et al. RESULTS The numbers of hip fractures for females, from 1988 to 1993, were similar to the number predicted, yet have been significantly lower than stated predictions since 1995. For males, hip fracture numbers since 1995 were less than the weighted regressions predicted (NS). CONCLUSIONS Numbers of hip fractures since 1995 have been fewer than predicted. Possible reasons for maintaining the rates of hospitalisation due to fractured neck of femur at pre-1995 levels, are discussed.
Collapse
Affiliation(s)
- J Fielden
- Department of Surgery, Wellington School of Medicine
| | | | | | | |
Collapse
|
37
|
Abstract
D-myo-Inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4] is produced rapidly from the established second messenger D-myo-inositol 1,4,5-trisphosphate [Ins(1,4,5)P4] in stimulated cells. Despite extensive investigations, in particular concerning its potential role in mediating cellular Ca2+ influx, no exact cellular function has been described for this inositol phosphate; however, binding sites have been identified in a number of tissues and it has been shown to act synergistically with Ins(1,4,5)P3. To assist in the elucidation of the mechanism of action and structural requirements within the Ins(1,3,4,5)P4 moiety that are necessary for recognition and activation of the receptor, structural analogues of this tetrakisphosphate are required. Routes for the synthesis of racemic 6-deoxy-myo-inositol 1,3,4,5-tetrakisphosphate [6-deoxy-DL-Ins(1,3,4,5)P4] and the chiral antipodes D- and L-6-deoxy-myo-inositol 1,3,4,5-tetrakisphosphate are described here. The racemic tetrakisphosphate was synthesised from DL-1,2-O-isopropylidene-myo-inositol in eight steps. Deoxygenation at C-6 was achieved following the Barton-McCombie procedure. Both chiral tetrakisphosphates were synthesised through resolution of racemic cis-diol 6-deoxy-1,4,5-tri-O-p-methoxybenzyl-myo-inositol with the chiral auxiliary (S)-(+)-O-acetylmandelic acid. Absolute configuration was confirmed by synthesis of the known D-6-deoxy-myo-inositol. Both D-6-deoxy-Ins(1,3,4,5)P4 and its enantiomer will be useful tools to unravel the enigmatic role of Ins(1,3,4,5)P4 in the polyphosphoinositide pathway of signal transduction.
Collapse
Affiliation(s)
- G Horne
- Department of Pharmacy and Pharmacology, University of Bath, UK
| | | |
Collapse
|
38
|
Horne G, Atkinson A, Brison DR, Radford J, Yin JA, Edi-Osagie EC, Pease EH, Lieberman BA. Achieving pregnancy against the odds: successful implantation of frozen-thawed embryos generated by ICSI using spermatozoa banked prior to chemo/radiotherapy for Hodgkin's disease and acute leukaemia. Hum Reprod 2001; 16:107-109. [PMID: 11139546 DOI: 10.1093/humrep/16.1.107] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Two cases are reported of successful pregnancies following long-term semen banking prior to chemotherapy and radiotherapy for malignancy. With the first case, the patient banked semen at the age of 20 years prior to chemotherapy for Hodgkin's disease; 11 years later the thawed semen was used for IVF with intracytoplasmic sperm injection (ICSI), resulting in twins being born following the transfer of frozen-thawed embryos. In the second case, the patient banked semen at the age of 17 years prior to chemotherapy and radiotherapy for acute myeloid leukaemia; 8 years later it was used for ICSI, resulting in triplets being born following the transfer of frozen-thawed embryos. These cases support long-term semen banking for men whose future fertility may be compromised by suppression of spermatogenesis secondary to administration of chemo/radiotherapy treatment. The advent of successful ICSI combined with embryo cryopreservation has increased the chance of thawed cryopreserved semen achieving fertilization. Banking of a single ejaculate prior to commencement of chemotherapy/radiotherapy treatment may preserve potential fertility without compromising the oncology treatment.
Collapse
Affiliation(s)
- G Horne
- Department of Reproductive Medicine, St Mary's Hospital, Manchester M13 0JH, UK. greg.smh1.cmht.nwest.nhs.uk
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Beasley R, Delahunt B, Horne G, Maling T, Roberts P, Smith R, St George I, Tie A. Freedom of debate and legal threats. N Z Med J 2000; 113:298. [PMID: 10935575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
|
40
|
Abstract
Human embryos cryopreserved after in-vitro fertilisation can be stored initially for 5 years, and the storage period may be extended to a maximum of 10 years. Of 1344 embryos cryopreserved between 1988 and 1994 at two centres in Manchester, 67% (904 embryos) have had to be destroyed at the end of the first 5-year interval, even if the couples involved remain childless.
Collapse
|
41
|
Jones BL, Clark S, Curran ET, McNamee S, Horne G, Thakker B, Hood J. Control of an outbreak of respiratory syncytial virus infection in immunocompromised adults. J Hosp Infect 2000; 44:53-7. [PMID: 10633054 DOI: 10.1053/jhin.1999.0666] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Respiratory syncytial virus (RSV) is increasingly recognized as an important pathogen in immunocompromised adults, particularly those receiving bone marrow transplants, and, given the ease with which it spreads, represents a significant nosocomial problem. We describe an outbreak of RSV infection involving eight patients on a haematology/oncology ward which was controlled by early screening of patients and staff. Positive patients were cohort nursed on a separate ward and basic infection control measures including use of gowns and gloves were enforced. Children under age 12 were denied ward access. All patients with lower respiratory tract infection, and bone marrow transplant recipients with upper respiratory symptoms, were treated with nebulized ribavirin. There were no deaths. We conclude that awareness of the risk of RSV infection in immunocompromised patients coupled with rapid diagnosis and treatment, screening of symptomatic patients and staff, cohort nursing of cases and basic infection control procedures can prevent spread of RSV infection and reduce morbidity.
Collapse
Affiliation(s)
- B L Jones
- Department of Clinical Microbiology, Glasgow Royal Infirmary, Glasgow, G4 OSF, Scotland
| | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
BACKGROUND The outcome of surgical repair for recurrent anterior instability of the shoulder at the Wellington Hospital was reviewed. METHODS A retrospective review was undertaken of patients undergoing surgical repair for recurrent anterior instability of the shoulder at Wellington Hospital between October 1989 and November 1996. Patients were asked to complete two shoulder-specific questionnaires, and the range of motion, stability, and strength was evaluated clinically. RESULTS A total of 37 patients (38 shoulders) who had recurrent anterior dislocation of the shoulder that was unresponsive to a physician-directed rehabilitation programme were managed with open surgical repair. Procedures included the Putti-Platt, Bristow, Magnuson-Stack, Botychev, and Bankart repairs. The mean age at the time of surgery was 24 years and the male-to-female ratio was 11.3:1. Surgery was performed on the dominant side in 63.2% of shoulders. The postoperative redislocation rate was 39.4% at an average of 4.6 years follow-up. Three patients have since required revision of their surgical repair and one patient is awaiting revision. A total of 63.2% of patients were unable to return to their previous level of sports. Differences existed between the motion in the surgically treated shoulder when compared with the contralateral side. Patients reported the most functional difficulty in throwing, working overhead, pulling, and working at shoulder level. CONCLUSIONS The results of the present study indicate a high redislocation rate, and highlight the challenges in restoring a stable, mobile, functional shoulder.
Collapse
Affiliation(s)
- A J Yee
- Department of Surgery, Wellington School of Medicine, New Zealand
| | | | | |
Collapse
|
43
|
Horne G, Jamaludin A, Critchlow JD, Falconer DA, Newman MC, Oghoetuoma J, Pease EH, Lieberman BA. A 3 year retrospective review of intrauterine insemination, using cryopreserved donor spermatozoa and cycle monitoring by urinary or serum luteinizing hormone measurements. Hum Reprod 1998; 13:3045-8. [PMID: 9853853 DOI: 10.1093/humrep/13.11.3045] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Insemination with donor spermatozoa is an integral part of infertility treatment. For the last 3 years in our unit, intrauterine insemination with donor spermatozoa (IUID) has been used in preference to vaginal insemination. In this retrospective study, patients were offered an initial course of five single intrauterine inseminations with cryopreserved donor spermatozoa and treatment was then reviewed. A total of 389 patients received 1465 inseminations. In all, 1119 cycles were monitored using luteinizing hormone serum analyses and 346 cycles using the urine home test kits. The clinical pregnancy rate per insemination for the cycles monitored by the serum assay was 18.0% (202/1119) compared with the urine cycles (13.7%, 46/346) (P <05). The pregnancy loss rate was not significantly different (14.4%, 29/202 and 21.7%, 10/46) (serum and urine cycles respectively). The viable clinical pregnancy rate was significantly higher (P <03) for the serum cycles than for the cycles using the urinary monitoring (15.5%, 173/1119 and 10.4%, 36/346 respectively). The cycles monitored by serum assay had a significantly higher cumulative viable clinical pregnancy rate (P <0001) of 70.2% after nine inseminations compared with the urine monitored cycles of 54.8%. The majority of patients opted for the serum cycles, with a minority self-selecting the urine cycles mainly for travelling convenience. The explanation for the significant differences between the viable clinical pregnancy rates per insemination and the cumulative viable clinical pregnancy rates may be due to the sensitivity of the urine home test kit or the patients' interpretation of the result.
Collapse
Affiliation(s)
- G Horne
- Department of Reproductive Medicine, St Mary's Hospital, Manchester, UK
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Affiliation(s)
- T Wilson
- Department of Orthopaedics, Wellington Hospital, New Zealand
| | | | | |
Collapse
|
45
|
Horne G, Critchlow JD, Newman MC, Edozien L, Matson PL, Lieberman BA. A prospective evaluation of cryopreservation strategies in a two-embryo transfer programme. Hum Reprod 1997; 12:542-7. [PMID: 9130756 DOI: 10.1093/humrep/12.3.542] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A total of 364 consecutive patients requesting in-vitro fertilization (IVF) treatment were divided randomly into two groups. In the first group, two embryos in the original IVF cycle were allowed to divide prior to transfer, with any remaining embryos being cryopreserved at the pronucleate (PN) stage. In the second group, all the embryos were allowed to divide to the early cleavage (EC) stage, and the best two replaced; any suitable remaining embryos were frozen at the 2- to 4-cell stage. A total of 134 cycles (36.8%) fulfilled the study criteria for a fresh embryo replacement and supernumerary embryos cryopreserved. In the PN group, 72 out of 182 (39.6%) patients had a fresh embryo replacement accompanied by embryo cryopreservation, which was not significantly different from the EC group (62/182; 34.1%). The livebirth rate per fresh embryo transfer in the EC group (17/62; 27.4%) was significantly higher than that for the PN group (8/72; 11.1%; P < 0.05). Embryo survival following thawing was similar for the PN (96/129; 74.4%) and EC (79/102; 77.4%) stages. Although not significant, the livebirth rate following the transfer of thawed embryos was higher in the PN group (11/44; 25.0%) than in the EC group (4/38; 10.5%). Following one fresh and two freeze-thaw embryo replacements, the observed cumulative viable pregnancy rates were comparable for patients in both the PN (40.2%) and EC (41.1%) groups.
Collapse
Affiliation(s)
- G Horne
- Department of Reproductive Medicine, St Mary's Hospital, Manchester, UK
| | | | | | | | | | | |
Collapse
|
46
|
Mitchell R, Buckler HM, Matson P, Lieberman B, Burger HG, Hilton B, Horne G, Dyson M, Robertson WR. Oestradiol and immunoreactive inhibin-like secretory patterns following controlled ovarian hyperstimulation with urinary (Metrodin) or recombinant follicle stimulating hormone (Puregon). Hum Reprod 1996; 11:962-7. [PMID: 8671371 DOI: 10.1093/oxfordjournals.humrep.a019332] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Inhibin (and its alpha-subunit) may be of particular value as a marker for follicular development in in-vitro fertilization (IVF) in comparison with the classic follicle stimulating hormone (FSH)-dependent marker oestradiol in patients following pituitary desensitization and treatment with recombinant FSH (rFSH). This preparation lacks luteinizing hormone (LH), which is essential for thecal cell androgen secretion and thus oestradiol production. Our study has assessed oestradiol and immunoreactive inhibin-like secretion following ovarian stimulation with rFSH or a purified urinary FSH preparation (Metrodin) (uFSH). A randomized, assessor-blind study was initiated using patients receiving a single treatment cycle of IVF (using fresh embryos) following pituitary desensitization with intranasal buserelin (500 microg daily) and the i.m. injection of either rFSH (n = 38) or uFSH (n = 17). Ovarian ultrasound examinations were performed and bloods (10 ml) collected prior to FSH treatment and every 1-2 days until ovulation induction with human chorionic gonadotrophin. LH and FSH concentrations were measured by an immunoradiometric assay, and inhibin-like immunoreactivity by a radioimmunoassay and an enzyme-linked immunosorbent assay, both with alpha-subunit specificity. Oestradiol concentration was measured with a coated tube radioimmunoassay. Following desensitization, basal LH, FSH and oestradiol concentrations were measured, as was that of immunoreactive inhibin. Following treatment with either rFSH or uFSH, LH concentrations remained low while FSH concentrations rose to a plateau of 5.6-6.7 IU/l in both groups. In contrast, the concentration of oestradiol was higher (P < 0.05) with rFSH than with uFSH in the last four days of treatment, a pattern that was repeated for inhibin-like immunoreactivity. The change in oestradiol and inhibin concentrations during treatment was approximately 2-fold higher with rFSH. The total number of follicles obtained with rFSH was similar to that with uFSH. However, the number of follicles with a diameter of >/= 15 mm was higher the rFSH group, and there was a concomitant increase in the number of oocytes recovered. Oestradiol concentration and inhibin-like immunoreactivity (determined by either method) were associated with total follicle number and number of follicles >/= 15 mm in diameter, as well as with each other (P < 0.001). When ovarian hormone output was normalized per follicle produced, oestradiol output was higher for rFSH than for uFSH P = 0.04). Inhibin output was clearly higher using rFSH than uFSH. There were seven pregnancies (one miscarriage) with rFSH and two with uFSH. Despite similar concentrations od FSH in patients, rFSH (Puregon) appears to be more potent in vitro in terms of follicular number, ovarian hormone secretion (both concentration and output/follicle) and oocyte recovery. In both groups, LH concentrations of approximately 1.3 IU/l were sufficient to support oestradiol secretion similar to that normally found in IVF programmes using human menopausal gonadotrophin preparations containing large amounts of LH. Despite known problems of specificity with the assays od inhibin, its measurement was of similar value to oestradiol as a marker of follicular development.
Collapse
Affiliation(s)
- R Mitchell
- University of Manchester Department of Medicine, Hope Hospital, Eccles Old Road, Salford M6 8HD, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Rajapakse B, Horne G, Devane P, Rajapaske BN. Forearm and wrist fractures in mountain bike riders. N Z Med J 1996; 109:147-8. [PMID: 8649672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIMS To identify the different types of fractures of the forearm caused by mountain bike accidents, and to assess the physical and social consequences of these injuries. METHODS All the forearm fractures recorded in the Wellington Hospital fracture logs between July 1992 and July 1994 were reviewed in December 1994. Mountain bike accidents were identified in 37 patients. 11 patients could not be contacted and one patient declined participation, leaving 25 patients who participated in the study. Those who took part each completed a questionnaire and were examined. The radiographs of each patient were also reviewed. RESULTS Nine of the fractures occurred in the proximal third of the forearm and 16 occurred in the distal third. The most common fracture was that of the radial head (9). When functionally assessed 15 patients were graded excellent, 5 satisfactory, 4 unsatisfactory, and 1 patient was graded as poor. The average time off work was 28 days, with no change of occupation being necessitated in any of the patients. Eight patients had to make changes to their recreational activities. CONCLUSIONS The results of the study suggest that mountain bike accidents can result in significant injury. With adequate medical attention it appears that the majority of cases recover well, and experience only minimal discomfort without significant long term physical and social consequences.
Collapse
Affiliation(s)
- B Rajapakse
- Department of Surgery, Wellington School of Medicine
| | | | | | | |
Collapse
|
48
|
Watson P, Horne G, Firth A. Assessing services. Knowing the score. Health Serv J 1996; 106:28-31. [PMID: 10157034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
49
|
Burness R, Horne G, Purdie G. Albumin levels and mortality in patients with hip fractures. N Z Med J 1996; 109:56-7. [PMID: 8598940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AIM The aim of the study was to examine the serum albumin levels of patients admitted with hip fractures to see whether there was any relationship between serum albumin and subsequent mortality. METHODS A group of 39 consecutive patients with hip fractures was followed for a period of 12 months. The serum albumin was determined preoperatively. No patient was lost to follow up. RESULTS Ten patients died at 12 months. Those who died had a significantly lower serum albumin level than those alive at the end of the follow up period. CONCLUSIONS The results of this study show that preoperative serum albumin determination in patients with hip fractures is a useful guide to postfracture mortality.
Collapse
Affiliation(s)
- R Burness
- Wellington Hospital, Wellington School of Medicine, Wellington
| | | | | |
Collapse
|
50
|
Mills HJ, Horne G, Devane P. Osteosarcoma in New Zealand 1981-7: an overview. N Z Med J 1995; 108:458-9. [PMID: 8538963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
AIMS To examine the incidence, and results of treatment of osteosarcoma in New Zealand between 1981 and 1987. METHOD Data was obtained from the Cancer Registry for all patients registered with osteosarcoma between 1981 and 1987. RESULTS There were 104 patients in the study group. There was a peak incidence in the second decade with a second smaller peak in the seventh and eight decades. The overall 5 year survival rate was 29%. For the group aged under 30 years there was a 44% 5 year survival rate. Those aged over 60 years had a 3.2% 5 year survival. Survival rates were better when treated with surgery and chemotherapy and where the tumour was of the appendicular skeleton. CONCLUSION This is a mixed group of patients. The 5 year survival rates appear to be at the lower end of the spectrum of the results reported for similar groups in other countries.
Collapse
Affiliation(s)
- H J Mills
- Department of Surgery, Wellington School of Medicine
| | | | | |
Collapse
|