Oocyte zona pellucida and meiotic spindle birefringence as a biomarker of pregnancy rate outcome in IVF-ICSI treatment

Objectives: IVF-ICSI procedures are accompanied by a continuous search for predictors of ART outcome. The properties of zona pellucida (ZP) have been believed to reflect the history of oocyte cytoplasmic maturation. The meiotic spindle (MS) is crucial for chromosomal alignment and proper separation of the maternal chromosomes. There is data suggesting that birefringent ZP and MS can clinically predict the oocyte quality and developmental potential of an embryo. The aim of the study was to examine the possible effect of ZP birefringent properties and MS visualization and localization as valuable predictors of IVF-ICSI effectiveness. Material and methods: The prospective study was performed during a 16-month period. A total of 51 patients undergoing in vitro fertilization - embryo transfer (IVF-ET) treatment procedure with intracytoplasmic sperm injection (ICSI) were included. Controlled ovarian hyperstimulation (COH) was done using either a long n=32 (62.75%) or an antagonist protocol n=19. In the group of the 48 examined patients (aged 25-40), 46 ET were performed, resulting in 24 positive pregnancy tests and 19 (39.59%) clinical pregnancies. Oocytes were examined as follows: ZP birefringence autoscoring (OCTAX PolarAIDE), numeral autoscoring, thickness and clinical evaluation; MS visualization, if MS was visualized, localization of MS in relation to the polar body (PB). Results: On day 3, 64.3% of the embryos were of good and 40.3% were of top quality. Visible differences, not statistically significant, were observed in the numeral score of ZP between oocytes selected and non-selected for ET. In cases when embryos were not of good or top quality, ZP score was higher (p=0.005 p=0.001). ZP manual evaluation indicated significantly stronger birefringence when pregnancy was not achieved (p=0.022). The rate of MS positive oocytes was the highest in the group with pregnancy, but it did not reach statistical significance (p=0.471). The MS localization in relation to the PB was in most oocytes very close

Analiza profilu demograficznego pacjentów leczonych z powodu niepłodności metodami rozrodu wspomaganego w latach 2005-2010

Objectives: analysis of the demographic profile of patients, causes for infertility and effectiveness of infertility treatment methods in the years 2005-2010. Material and methods: Retrospective research was conducted to analyze data of 1705 randomly selected couples who underwent in vitro fertilization procedure at the Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, between 2005 and 2010. The analyzed data included mainly causes for infertility, age of the female and male subjects, place of residence and final treatment results. Results: The percentage of pregnancy rate increased significantly to approximately 40% in 2007. The contribution of male and female infertility factors remained at a similar level, but the idiopathic factor continued to steadily increase (to 20% in the last years of the study). We observed a greater prevalence of the male factor among couples living in cities compared to inhabitants of rural areas (42.3% vs. 34.3%, p=0.004), whereas the tubal factor dominated among couples living in the countryside when compared to city dwellers (29.7% vs. 21.6%, p=0.001). The average age of women entering treatment was significantly higher in cities than the countryside (pCel pracy: Analiza profilu demograficznego pacjentów, przyczyn niepłodności oraz skuteczności leczenia metodami rozrodu wspomaganego w latach 2005-2010. Materiał i metody: W badaniu retrospektywnym przeanalizowano dane dotyczące 1705 losowo wybranych cykli leczenia niepłodności metodami rozrodu wspomaganego, przeprowadzonych w latach 2005-2010 w Klinice Rozrodczości i Endokrynologii Ginekologicznej Uniwersytetu Medycznego w Białymstoku. Wyniki: Odsetek uzyskanych ciąż wyraźnie wzrósł w 2007 roku do poziomu około 40%. Udział męskich i żeńskich czynników niepłodności kształtuje się na porównywalnym poziomie, stale wzrasta udział czynnika niewyjaśnionego pochodzenia (do około 20% w ostatnich latach badania). Wśród par z miasta stwierdza się większy niż na wsi odsetek występowania czynnika męskiego (42,3% vs. 34,3%, p=0,004), natomiast u par ze wsi – większy niż w miastach udział czynnika jajowodowego (29,7% vs. 21,6%, p=0,001). Przeciętny wiek kobiet podejmujących leczenie jest istotnie wyższy w mieście niż na wsi (

The impact of first wave of the SARS-CoV-2 2019 pandemic in Poland on characteristics and outcomes of patients hospitalized due to stable coronary artery disease

Background: An investigation of baseline characteristics, treatment, and outcomes in patients with stable coronary disease after the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic may provide valuable data and is beneficial for public health strategy in upcoming years. Methods: A multi-institutional registry, including 10 cardiology departments, was searched for patients admitted from June 2020 to October 2020. The baseline characteristics (age, gender, symptoms, comorbidities), treatment (non-invasive, invasive, surgical), and hospitalization outcome (mortality, myocardial infarction, stroke, composite endpoint — major adverse cardiac and cerebrovascular events [MACCE]) were evaluated. The comparison was made to parameters presented by patients from the same timeframe in 2019 (June–October). Multivariable analysis was performed. Results: Number of hospitalized stable patients following lockdown was lower (2498 vs. 1903; p < 0.0001). They were younger (68.0 vs. 69.0; p < 0.019), more likely to present with hypertension (88.5% vs. 77.5%; p < 0.0001), diabetes (35.7% vs. 31.5%; p = 0.003), hyperlipidemia (67.9% vs. 55.4%; p < 0.0001), obesity (35.8% vs. 31.3%; p = 0.002), and more pronounced symptoms (Canadian Cardiovascular Society [CCS] III and CCS class IV angina: 30.4% vs. 26.5%; p = 0.005). They underwent percutaneous treatment more often (35.0% vs. 25.9%; p < 0.0001) and were less likely to be referred for surgery (3.7% vs. 4.9%; p = 0.0001). There were no significant differences in hospitalization outcome. New York Heart Association (NYHA) class IV for heart failure was a risk factor for both mortality and MACCE in multivariate analysis. Conclusions: The SARS-CoV-2 2019 pandemic affected the characteristics and hospitalization course of stable angina patients hospitalized following the first wave. The hospitalization outcome was similar in the analyzed time intervals. The higher prevalence of comorbidities raises concern regarding upcoming years

Placenta is Capable of Protecting the Male Fetus from Exposure to Environmental Bisphenol A

Embryo-fetal exposure to bisphenol A (BPA) could be related to poor male reproductive parameters in rodents, but this concept has not been convincingly confirmed in humans. We investigated the association of environmental BPA exposure of pregnant women with selected endocrine and anthropometric parameters of male newborns. We analyzed plasma BPA from pregnant mothers, umbilical cord, and placental tissues (n = 117/each group) by liquid chromatography and mass spectrometry. LH, FSH, AMH, TGF beta 2, inhibin B, and selected sex steroids were measured in cord plasma. The infant anthropometric parameters included anogenital distance, stretched penile length, head circumference, birthweight, and length. The median BPA concentrations in maternal and umbilical cord plasma, and in placental tissue were 19.0, 8.0, and 22.2 nmol/L, respectively, the levels thus being over twofold lower in the fetal circulation than in the mother or placenta. The BPA concentrations measured were 100-1000-fold lower than those demonstrated in animal experiments to have endocrine disrupting effects. Multivariable regression analysis indicated no significant correlations between the maternal/fetal/placental BPA concentrations and any of the hormone levels or anthropometric parameter measured. Plasma concentrations of BPA confirmed both maternal, placenta, and fetal exposure to environmental BPA, but the concentrations were orders of magnitude lower than those with documented endocrine disrupting activity. Moreover, the maternal/fetal concentration gradient as well as the lack of correlations of BPA levels with any major endocrine or anthropometric parameters measured in the newborns suggest a protective role for the placenta in reducing fetal exposure to the environmental BPA

Safety and feasibility of minimally invasive coronary artery bypass surgery early after drug eluting stent implantation due to acute coronary syndrome

Background: The evidence of performing minimally invasive coronary artery surgery early after drug eluting stent (DES) implantation due to acute coronary syndrome (ACS) is limited. Aim: The aim of the study is to determine the safety and feasibility of this approach. Methods: This registry includes 115  (78% male) patients from 2013‒2018, who underwent non-LAD percutaneous coronary intervention (PCI) due to ACS with contemporary DES implantation (39% diagnosed with myocardial infarction at baseline), followed by endoscopic atraumatic coronary artery bypass (EACAB) surgery within 180 days, after temporary P2Y12 inhibitor discontinuation. Primary composite endpoint of MACCE (Major Adverse Cardiac and Cerebrovascular Events), defined as death, myocardial infarction (MI), cerebrovascular incident and repeat revascularization was evaluated in long- term follow-up. The follow-up was collected via telephone survey and with National Registry for Cardiac Surgery Procedures. Results: Median (interquartile range [IQR]) time interval separating both procedures was 100.0 (62.0‒136.0) days. Median (IQR) follow-up duration was 1338.5 (753.0‒2093.0) days and was completed from all patients with regard to mortality. Eight patients (7%) died; 2 (1.7%) had a stroke; 6 (5.2%) suffered from MI and 12 (10.4%) required repeat revascularization. Overall, the incidence of MACCE was 20 (17.4%). Conclusions: EACAB is a safe and feasible method of LAD revascularization in patients who received DES for ACS within 180 days prior to surgery, despite early dual antiplatelet therapy discontinuation. The adverse event rate is low and acceptable

Actual status and future directions of cardiac telerehabilitation

Telerehabilitation (TR) was developed to achieve the same results as would be achieved by the standard rehabilitation process and to overcome potential geographical barriers and staff deficiencies. This is especially relevant in periodic crisis situations, including the current COVID-19 pandemic. Proper execution of TR strategy requires both well-educated staff and dedicated equipment. Various studies have shown that TR may have similar effects to traditional rehabilitation in terms of clinical outcomes and may also reduce total healthcare costs per participant, including rehospitalization costs. However, as with any method, TR has its advantages and disadvantages, including a lack of direct contact or prerequisite, rudimentary ability of the patients to handle mobile devices, among other competencies. Herein, is a discussion of the current status of TR, focusing primarily on cardiac TR, describing some technical/organizational and legal aspects, highlighting the indications, examining cost-effectiveness, as well as outlining possible future directions

Właściwości tribologiczne powłok diamentopodobnych w węzłach tarcia smarowanych cieczą jonową

The paper reports the study of a-C: H and a-C:H:Si diamond-like carbon coatings obtained in plasma-assisted chemical vapour deposition processes PACVD. The influence of the coatings on tribological properties of tribopairs under dry friction and in lubrication with synthetic oil PAO-8 and selected ionic liquid was evaluated. To perform the analysis, 100Cr6 steel samples uncoated and coated with a-C:H and a-C:H:Si were compared. Surface topography studies were performed using an atomic force microscope. Using SEM with an EDS analyser, the surface morphology of the coatings was observed, and the elements contained in the coatings were identified. Tribotests were carried out in a ball-on-disc tribotester under dry friction and with lubricants. The characteristics of the texture of the samples before and after the tribotests were determined using a confocal microscope in an interferometric mode. The test results showed that the tribo-pairs with a-C:H in lubrication with ionic liquid had the best tribological characteristics, i.e., the lowest coefficient of sliding friction.Artykuł dotyczy badań powłok diamentopodobnych typu a-C:H oraz domieszkowanych krzemem a-C:H:Si uzyskiwanych w procesach chemicznego osadzania z fazy gazowej wspomaganych plazmą PACVD. Poddano ocenie wpływ powłok na właściwości tribologiczne węzłów tarcia w warunkach tarcia technicznie suchego oraz smarowania olejem syntetycznym PAO-8 i cieczą jonową bis(trifluorometylosulfonylo) amidem triheksylotetradecylofosfoniowym. W celu przeprowadzenia analizy porównano próbki ze stali 100Cr6 oraz pokryte diamond-like carbon coating typu a-C:H oraz a-C:H:Si. Badania topografii powierzchni wykonano na mikroskopie sił atomowych. Obserwacje morfologii powierzchni i identyfikację pierwiastków przeprowadzono przy użyciu skaningowego mikroskopu elektronowego z analizatorem EDS. Badania tribologiczne przeprowadzono na tribotesterze pracującym w skojarzeniu kula–tarcza w warunkach tarcia technicznie suchego oraz tarcia z zastosowaniem substancji smarowych. Charakterystykę struktury geometrycznej próbek przed oraz po badaniach tribologicznych wykonano mikroskopem konfokalnym z trybem interferometrycznym. Wyniki badań wskazały, że najlepszymi charakterystykami tribologicznymi – najmniejszym współczynnikiem tarcia w ruchu ślizgowym charakteryzowały się pary trące z diamond-like carbon coating typu a-C:H w warunkach smarowania cieczą jonową

The properties of lubricated friction pairs with diamond-like carbon coatings

The purpose of the study was to evaluate the properties of diamond-like carbon DLC coatings with ionic liquids and cutting fluid containing zinc aspartate used as lubricants. The DLC coatings (a–C:H) were deposited onto the 100Cr6 steel substrate by physical vapour deposition PVD. The surface morphology testing, cross section and chemical composition analyses of the DLC coatings were performed using the scanning electron microscope, equipped with an EDS microanalyzer. Surface geometry measurements prior to and after tribological tests were performed on a confocal microscope with interferometry. The tribological tests were carried out on an Anton Paar TRB3 tribometer under technically dry friction and lubricated conditions with an ionic liquid, trihexyltetradecylphosphonium bis (trifluoromethylsulfonyl) imide and 1–butyl– 3–methylimidazolium bis (trifluoromethylsulfonyl) imide and cutting fluid with zinc aspartate. The results show that DLC coatings and ionic liquids can significantly reduce resistance to motion

Incidence and course of acute coronary syndrome cases following first wave of COVID-19 pandemic

BACKGROUND: The collateral damage caused by the COVID-19 pandemic influences cardiovascular disease patients, mainly acute coronary syndrome (ACS) cases. Additionally, lockdown has caused treatment-related concerns and reluctance, factors that can delay treatment. AIM: To analyse the incidence and course of ACS patients following the first COVID-19 wave. METHODS: The report represents a multi-institutional registry of 10 interventional cardiology departments. ACS patient data were gathered from June to October 2020, the period following the first lockdown in Poland (March 30–May 31, 2020), and compared with the corresponding 2019 timeframe. RESULTS: Patients (2801 and 2620) hospitalized for ACS in 2019 and 2020 (June–October), represent 52.8% and 57.9% of coronary artery disease admissions, respectively. In 2020 vs. 2019, more cases of arterial hypertension (80.2% vs. 71.5%; P <0.001), diabetes (32.7% vs. 28.2%; P <0.001), hyperlipidaemia (53.2% vs. 49.8%; P = 0.01) and smoking history (29.5% vs. 25.8%; P = 0.003) were detected. Median troponin and cholesterol values, as well as glycemia were higher in 2020. Patients were more likely to undergo percutaneous treatment (91.2% vs. 87.5%; P <0.001) and less often referred for surgery (3.7% vs. 4.9%; P = 0.03). No differences in deaths, repeat myocardial infarction, stroke, and/or composite endpoint (major adverse cardiac and cerebrovascular events [MACCE]) were noted. However, suffering from ACS in 2020 (June–October) was a risk factor for mortality based on a multivariable analysis. CONCLUSIONS: The COVID-19 pandemic affects ACS patient profile, course of treatment, and increases risk for mortality