19 research outputs found
Troponin T in COVID-19 hospitalized patients: Kinetics matter
Background: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19.Methods: Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality.Results: Two hundred and two patients were included in the analysis (mean age 64.4 ± 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 ± 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009â3.231; p = 0.009, HR 2.322, 95% CI 1.234â4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000â1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914â4.954, p = 0.000, HR 2.851, 95% CI 1.828â4.447).Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management
Extension de lâAMP aux demandes sociĂ©tales: questionnements Ă©thiques et juridiques
International audienceA ce jour, lâutilisation en France des techniques dâaide mĂ©dicale Ă la procrĂ©ation, vise Ă remĂ©dier aux infertilitĂ©s de couple relevant dâune origine mĂ©dicale ou Ă Ă©viter la transmission dâune affection dâune particuliĂšre gravitĂ© Ă la descendance du couple. Lâhomme et la femme formant le couple doivent ĂȘtre vivants et consentants pour bĂ©nĂ©ficier de ces techniques utilisant leurs propres gamĂštes ou les gamĂštes dâun tiers donneur. Une Ă©volution de la loi est en discussion et ces techniques pourraient alors ĂȘtre accessibles aux couples de femmes ou aux femmes seules. Cette soirĂ©e de discussion permettra dâaborder des questionnements en termes dâĂ©galitĂ© reproductive des hommes et des femmes ou dâĂ©quitĂ© dans lâaccĂšs Ă ces techniques.Des questions juridiques concernant la famille et la filiation seront Ă©galement abordĂ©es. AprĂšs deux courtes prĂ©sentations de la problĂ©matique, une large place sera faite Ă la discussion
Extension de lâAMP aux demandes sociĂ©tales: questionnements Ă©thiques et juridiques
International audienceA ce jour, lâutilisation en France des techniques dâaide mĂ©dicale Ă la procrĂ©ation, vise Ă remĂ©dier aux infertilitĂ©s de couple relevant dâune origine mĂ©dicale ou Ă Ă©viter la transmission dâune affection dâune particuliĂšre gravitĂ© Ă la descendance du couple. Lâhomme et la femme formant le couple doivent ĂȘtre vivants et consentants pour bĂ©nĂ©ficier de ces techniques utilisant leurs propres gamĂštes ou les gamĂštes dâun tiers donneur. Une Ă©volution de la loi est en discussion et ces techniques pourraient alors ĂȘtre accessibles aux couples de femmes ou aux femmes seules. Cette soirĂ©e de discussion permettra dâaborder des questionnements en termes dâĂ©galitĂ© reproductive des hommes et des femmes ou dâĂ©quitĂ© dans lâaccĂšs Ă ces techniques.Des questions juridiques concernant la famille et la filiation seront Ă©galement abordĂ©es. AprĂšs deux courtes prĂ©sentations de la problĂ©matique, une large place sera faite Ă la discussion
Extension de lâAMP aux demandes sociĂ©tales: questionnements Ă©thiques et juridiques
International audienceA ce jour, lâutilisation en France des techniques dâaide mĂ©dicale Ă la procrĂ©ation, vise Ă remĂ©dier aux infertilitĂ©s de couple relevant dâune origine mĂ©dicale ou Ă Ă©viter la transmission dâune affection dâune particuliĂšre gravitĂ© Ă la descendance du couple. Lâhomme et la femme formant le couple doivent ĂȘtre vivants et consentants pour bĂ©nĂ©ficier de ces techniques utilisant leurs propres gamĂštes ou les gamĂštes dâun tiers donneur. Une Ă©volution de la loi est en discussion et ces techniques pourraient alors ĂȘtre accessibles aux couples de femmes ou aux femmes seules. Cette soirĂ©e de discussion permettra dâaborder des questionnements en termes dâĂ©galitĂ© reproductive des hommes et des femmes ou dâĂ©quitĂ© dans lâaccĂšs Ă ces techniques.Des questions juridiques concernant la famille et la filiation seront Ă©galement abordĂ©es. AprĂšs deux courtes prĂ©sentations de la problĂ©matique, une large place sera faite Ă la discussion
Sperm Meiotic Segregation Analysis of Reciprocal Translocations Carriers: We Have Bigger FISH to Fry
Reciprocal translocation (RT) carriers produce a proportion of unbalanced gametes that expose them to a higher risk of infertility, recurrent miscarriage, and fetus or children with congenital anomalies and developmental delay. To reduce these risks, RT carriers can benefit from prenatal diagnosis (PND) or preimplantation genetic diagnosis (PGD). Sperm fluorescence in situ hybridization (spermFISH) has been used for decades to investigate the sperm meiotic segregation of RT carriers, but a recent report indicates a very low correlation between spermFISH and PGD outcomes, raising the question of the usefulness of spermFISH for these patients. To address this point, we report here the meiotic segregation of 41 RT carriers, the largest cohort reported to date, and conduct a review of the literature to investigate global segregation rates and look for factors that may or may not influence them. We confirm that the involvement of acrocentric chromosomes in the translocation leads to more unbalanced gamete proportions, in contrast to sperm parameters or patient age. In view of the dispersion of balanced sperm rates, we conclude that routine implementation of spermFISH is not beneficial for RT carriers
Is sperm FISH analysis still useful for Robertsonian translocations? Meiotic analysis for 23 patients and review of the literature
RĂ©sumĂ© Contexte Le mode de sĂ©grĂ©gation chromosomique le plus frĂ©quemment observĂ© chez les patients porteurs de translocation robertsonienne est. un mode Ă©quilibrĂ©. Les donnĂ©es semblent varier peu selon la translocation analysĂ©e. La relative constance des rĂ©sultats dans le cas de ces translocations robertsoniennes rend elle inutile ces analyses chromosomiques pour ces patients? Patients et mĂ©thodes Nous avons analysĂ© de façon rĂ©trospective les donnĂ©es spermatiques et de sĂ©grĂ©gation mĂ©iotique de 23 patients porteurs de translocation robertsonienne, de 2003 Ă 2017 et comparĂ© les rĂ©sultats observĂ©s Ă ceux dĂ©crits dans la littĂ©rature pour 187 patients. RĂ©sultats Le mode de sĂ©grĂ©gation alterne est. prĂ©pondĂ©rant dans notre sĂ©rie de patients avec 73.45% ±8.05 de spermatozoĂŻdes Ă©quilibrĂ©s (min 50.92%; max 89.99%). Ces rĂ©sultats sont en accord avec les donnĂ©es de la littĂ©rature, toutes translocations confondues et selon le type de translocation (pâ>â0.05) sauf pour la translocation der(13;15) oĂč ces taux sont significativement plus faibles (pâ<â0.05 vs der(13;14), der(14;21), (13;21) et der(15;22)). Nous observons Ă©galement des taux de spermatozoĂŻdes Ă©quilibrĂ©s significativement plus Ă©levĂ©s chez les patients Ă spermogramme normal (pâ<â0.01). Conclusions Les diffĂ©rences observĂ©es dans les taux dâaneuploĂŻdies entre les translocations der(13;15) et les autres translocations robertsoniennes et entre les porteurs de translocation Ă spermogramme normal ou altĂ©rĂ©, et lâutilitĂ© de ces donnĂ©es dans le conseil gĂ©nĂ©tique conduisent Ă poursuivre lâanalyse systĂ©matique de la sĂ©grĂ©gation mĂ©iotique pour les patients porteurs de translocations robertsoniennes et ceci particuliĂšrement pour les translocations rares
Donor sperm insemination after failed intra-couple intracytoplasmic sperm injection
International audienc
Predictive factors for an increased risk of sperm aneuploidies in oligo-astheno-teratozoospermic males
E-mail Address : [email protected] audiencePatients with severe spermatogenesis impairment can now successfully father a child thanks to the use of intracytoplasmic sperm injection (ICSI). In oligozoospermic patients, many studies have reported significantly higher sperm aneuploidy rates and therefore an increased risk of transmitting a chromosomal abnormality via the injection of abnormal spermatozoa. However, the frequency of aneuploidy is highly variable between patients. The aim of the present work was to identify clinical and biological factors, which, together with non-obstructive oligozoospermia, could be predictive of elevated sperm aneuploidies. The sperm aneuploidy rates for chromosomes X, Y, 13, 18 and 21 were assessed in 31 infertile men with well-characterized spermatogenesis impairment, and in a population of control men with proven fertility. The frequency of sperm aneuploidy was compared between several patient subgroups according to their clinical and biological factors. Nearly half of the oligozoospermic males (15/31) had a significantly increased disomy rate for at least one of the five chromosomes compared with that observed in the control population (mean disomy rates + 1.96 standard deviation). Factors significantly associated with higher numbers of aneuploid sperm were cigarette smoking, an elevated follicle-stimulating hormone level, a sperm concentration less than 1 M/mL, and a severe teratozoospermia. Hence, several factors predictive of an increased risk of sperm aneuploidy rates were identified in ICSI male candidates with a non-obstructive oligozoospermia
PROK1 Level in the Follicular Microenvironment: A New Noninvasive Predictive Biomarker of Embryo Implantation
International audienceProkineticin 1 (PROK1), also called endocrine gland-derived vascular endothelial growth factor, is a well-established regulator of endometrial receptivity and placental development. However, its clinical usefulness as a noninvasive predictive biomarker of embryo implantation is yet to be validated.PROK1 levels in FF and FCM could constitute new predictive noninvasive markers of successful embryo implantation in conventional in vitro fertilization-embryo transfer