21 research outputs found
UK Criteria for Uterus Transplantation: A Review
Absolute Uterine Factor Infertility (AUFI) is the final hurdle for assisted reproductive
treatments. Uterus transplant trials are happening worldwide; in order to advance the
debate around uterine transplantation (UTx) this article considers selection criteria for
clinical trials from a UK perspective and makes recommendations for future selection
criteria for UTx treatment. Recommendations advanced include the use of donor eggs,
access for single women and women in same-sex relationships, prohibiting
participation of women who are already mothers, and a preference for deceased
donors and bioengineered uteri. With UTx treatment on the horizon it is important to
proactively consider future selection criteria
Uterine transplantation: a systematic review
Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women
Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program
OBJECTIVE: This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep. METHOD: The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of SĂŁo Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed. RESULTS: The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period. CONCLUSION: We describe the success of four uterine auto-transplants in sheep models
Clinical patterns and seasonal trends in respiratory syncytial virus hospitalizations in SĂŁo Paulo, Brazil Padrões clĂnicos e sazonalidade das hospitalizações causadas pelo vĂrus respiratĂłrio sincicial em SĂŁo Paulo, Brasil
The respiratory viruses are recognized as the most frequent lower respiratory tract pathogens for infants and young children in developed countries but less is known for developing populations. The authors conducted a prospective study to evaluate the occurrence, clinical patterns, and seasonal trends of viral infections among hospitalized children with lower respiratory tract disease (Group A). The presence of respiratory viruses in children's nasopharyngeal was assessed at admission in a pediatric ward. Cell cultures and immunofluorescence assays were used for viral identification. Complementary tests included blood and pleural cultures conducted for bacterial investigation. Clinical data and radiological exams were recorded at admission and throughout the hospitalization period. To better evaluate the results, a non- respiratory group of patients (Group B) was also constituted for comparison. Starting in February 1995, during a period of 18 months, 414 children were included- 239 in Group A and 175 in Group B. In Group A, 111 children (46.4%) had 114 viruses detected while only 5 children (2.9%) presented viruses in Group B. Respiratory Syncytial Virus was detected in 100 children from Group A (41.8%), Adenovirus in 11 (4.6%), Influenza A virus in 2 (0.8%), and Parainfluenza virus in one child (0.4%). In Group A, aerobic bacteria were found in 14 cases (5.8%). Respiratory Syncytial Virus was associated to other viruses and/or bacteria in six cases. There were two seasonal trends for Respiratory Syncytial Virus cases, which peaked in May and June. All children affected by the virus were younger than 3 years of age, mostly less than one year old. Episodic diffuse bronchial commitment and/or focal alveolar condensation were the clinical patterns more often associated to Respiratory Syncytial Virus cases. All children from Group A survived. In conclusion, it was observed that Respiratory Syncytial Virus was the most frequent pathogen found in hospitalized children admitted for severe respiratory diseases. Affected children were predominantly infants and boys presenting bronchiolitis and focal pneumonias. Similarly to what occurs in other subtropical regions, the virus outbreaks peak in the fall and their occurrence extends to the winter, which parallels an increase in hospital admissions due to respiratory diseases.<br>Os vĂrus respiratĂłrios sĂŁo reconhecidos como os mais frequentes patĂłgenos do trato respiratĂłrio inferior para lactentes e crianças de idade reduzida em paĂses desenvolvidos, mas o conhecimento sobre este fato Ă© menor nos paĂses em desenvolvimento.Os autores realizaram um estudo prospectivo para avaliar a ocorrĂŞncia, os padrões clĂnicos e a sazonalidade das infecções virais entre as crianças hospitalizadas com doença do trato respiratĂłrio inferior (grupo A). A presença de vĂrus respiratĂłrios na nasofaringe das crianças foi avaliada Ă admissĂŁo em uma enfermaria de pediatria. A cultura celular e a imunofluorescĂŞncia foram utilizadas para identificação viral. Exames complementares incluiram culturas de sangue e lĂquido pleural para detecção de bactĂ©rias. Dados clĂnicos e exames radiolĂłgicos foram anotados na admissĂŁo e durante o perĂodo de internação. Para avaliar adequadamente os resultados foi constituĂdo um grupo sem doença respiratĂłria para comparação. Com inĂcio em fevereiro de 1995, durante um perĂodo de 18 meses, 414 crianças foram incluĂdas - 239 no grupo A e 175 no grupo B. No grupo A, 111 crianças (46,4%) tinham vĂrus enquanto somente 5 (2,9%) apresentavam vĂrus no grupo B. O VĂrus RespiratĂłrio Sincicial foi detectado em 100 crianças do grupo A (41,8%), o AdenovĂrus em 11 (4,6%), o vĂrus Influenza em 2 (0,8%), e o Parainfluenza em uma criança (0,4%). No grupo A as bactĂ©rias foram encontradas em 14 casos (5,8%). O VĂrus RespiratĂłrio Sincicial estava associado a outro vĂrus ou bactĂ©ria em seis casos. Ocorreram dois surtos de VĂrus RespiratĂłrio Sincicial, com pico em maio e junho. Todas as crianças acometidas por este vĂrus tinham idade inferior a 3 anos, na sua maior parte menos de um ano de idade. O acometimento bronquial episĂłdico e difuso e/ou a condensação alveolar focal, foram os padrões clĂnicos mais frequentemente associados aos casos de infecção pelo VĂrus RespiratĂłrio Sincicial. Todas as crianças do grupo A sobreviveram. Em conclusĂŁo, foi observado que o VĂrus RespiratĂłrio Sincicial foi o patĂłgeno mais frequentemente encontrado em crianças hospitalizadas por doença respiratĂłria grave. As crianças afetadas eram predominantemente lactentes do sexo masculino com bronquiolite e pneumonias focais. De modo similar ao que ocorre em outras regiões subtropicais os surtos do vĂrus tĂŞm pico no outono, extendem-se ao inverno, e se acompanham de um aumento nas internações hospitalares por doença respiratĂłria