Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies

Purpose: An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. Methods: The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). Results: Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258-5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. Conclusion: ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. Implications for cancer survivors: Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes

Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies

Abstract Purpose An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. Methods The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). Results Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258–5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. Conclusion ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. Implications for Cancer Survivors Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes

Genetic and lifestyle risk factors for MRI-defined brain infarcts in a population-based setting.

OBJECTIVE: To explore genetic and lifestyle risk factors of MRI-defined brain infarcts (BI) in large population-based cohorts. METHODS: We performed meta-analyses of genome-wide association studies (GWAS) and examined associations of vascular risk factors and their genetic risk scores (GRS) with MRI-defined BI and a subset of BI, namely, small subcortical BI (SSBI), in 18 population-based cohorts (n = 20,949) from 5 ethnicities (3,726 with BI, 2,021 with SSBI). Top loci were followed up in 7 population-based cohorts (n = 6,862; 1,483 with BI, 630 with SBBI), and we tested associations with related phenotypes including ischemic stroke and pathologically defined BI. RESULTS: The mean prevalence was 17.7% for BI and 10.5% for SSBI, steeply rising after age 65. Two loci showed genome-wide significant association with BI: FBN2, p = 1.77 × 10-8; and LINC00539/ZDHHC20, p = 5.82 × 10-9. Both have been associated with blood pressure (BP)-related phenotypes, but did not replicate in the smaller follow-up sample or show associations with related phenotypes. Age- and sex-adjusted associations with BI and SSBI were observed for BP traits (p value for BI, p [BI] = 9.38 × 10-25; p [SSBI] = 5.23 × 10-14 for hypertension), smoking (p [BI] = 4.4 × 10-10; p [SSBI] = 1.2 × 10-4), diabetes (p [BI] = 1.7 × 10-8; p [SSBI] = 2.8 × 10-3), previous cardiovascular disease (p [BI] = 1.0 × 10-18; p [SSBI] = 2.3 × 10-7), stroke (p [BI] = 3.9 × 10-69; p [SSBI] = 3.2 × 10-24), and MRI-defined white matter hyperintensity burden (p [BI] = 1.43 × 10-157; p [SSBI] = 3.16 × 10-106), but not with body mass index or cholesterol. GRS of BP traits were associated with BI and SSBI (p ≤ 0.0022), without indication of directional pleiotropy. CONCLUSION: In this multiethnic GWAS meta-analysis, including over 20,000 population-based participants, we identified genetic risk loci for BI requiring validation once additional large datasets become available. High BP, including genetically determined, was the most significant modifiable, causal risk factor for BI

The Influence of a Padded Hand Wrap on Punching Force in Elite and Untrained Punchers

Punching is integral to success in combat sports, making it a frequent activity during practice/training. Improving safety of this activity benefits both the athlete and training partners. This study was designed to 1) test the precision and reliability of a commercially available striking device and 2) assess the influence of a novel padded hand wrap on punching force in elite and untrained punchers. Fourteen male professional boxers and mixed martial artists (PRO; age=29.2±5.6y; height=180.3±9.0cm; mass=87.1±17.9kg, winning %=73.8±13.8%, number of victories via knockout/technical knockout=35.6± 21.9%) and 24 untrained male punchers (UNT; 27.6±6.9y, 177.6±18.3cm, 84.3±16.9kg) wore a standardized boxing glove and performed 20 maximal punches (4 sets of 5) into a device designed to measure punching force. All participants performed, in a counterbalanced order, 2 sets of 5 with a standardized hand wrap and 2 sets of 5 with the same wrap plus an additional 1.2cm thick cylinder 4g foam-like pad (WRAP) placed over the knuckles. PRO produced significantly more punching force than UNT, regardless of condition. Punching force was lower by 12.6% (p\u3c0.05) for PRO and 8.9% (p\u3c0.05) for UNT with WRAP (compared to no WRAP). These findings suggest WRAP significantly reduces punching force, which may be important for long-term safety of the puncher’s hand and/or the person receiving the strike

The Influence of a Padded Hand Wrap on Punching Force in Elite and Untrained Punchers

Punching is integral to success in combat sports, making it a frequent activity during practice/training. Improving safety of this activity benefits both the athlete and training partners. This study was designed to 1) test the precision and reliability of a commercially available striking device and 2) assess the influence of a novel padded hand wrap on punching force in elite and untrained punchers. Fourteen male professional boxers and mixed martial artists (PRO; age=29.2±5.6y; height=180.3±9.0cm; mass=87.1±17.9kg, winning %=73.8±13.8%, number of victories via knockout/technical knockout=35.6± 21.9%) and 24 untrained male punchers (UNT; 27.6±6.9y, 177.6±18.3cm, 84.3±16.9kg) wore a standardized boxing glove and performed 20 maximal punches (4 sets of 5) into a device designed to measure punching force. All participants performed, in a counterbalanced order, 2 sets of 5 with a standardized hand wrap and 2 sets of 5 with the same wrap plus an additional 1.2cm thick cylinder 4g foam-like pad (WRAP) placed over the knuckles. PRO produced significantly more punching force than UNT, regardless of condition. Punching force was lower by 12.6% (p0.05) for PRO and 8.9% (p0.05) for UNT with WRAP (compared to no WRAP). These findings suggest WRAP significantly reduces punching force, which may be important for long-term safety of the puncher’s hand and/or the person receiving the strike.Keywords: safety, punching, striking, hitting, combat, pa

The Influence of a Padded Hand Wrap on Punching Force in Elite and Untrained Punchers

Punching is integral to success in combat sports, making it a frequent activity during practice/training. Improving safety of this activity benefits both the athlete and training partners. This study was designed to 1) test the precision and reliability of a commercially available striking device and 2) assess the influence of a novel padded hand wrap on punching force in elite and untrained punchers. Fourteen male professional boxers and mixed martial artists (PRO; age=29.2±5.6y; height=180.3±9.0cm; mass=87.1±17.9kg, winning %=73.8±13.8%, number of victories via knockout/technical knockout=35.6± 21.9%) and 24 untrained male punchers (UNT; 27.6±6.9y, 177.6±18.3cm, 84.3±16.9kg) wore a standardized boxing glove and performed 20 maximal punches (4 sets of 5) into a device designed to measure punching force. All participants performed, in a counterbalanced order, 2 sets of 5 with a standardized hand wrap and 2 sets of 5 with the same wrap plus an additional 1.2cm thick cylinder 4g foam-like pad (WRAP) placed over the knuckles. PRO produced significantly more punching force than UNT, regardless of condition. Punching force was lower by 12.6% (p0.05) for PRO and 8.9% (p0.05) for UNT with WRAP (compared to no WRAP). These findings suggest WRAP significantly reduces punching force, which may be important for long-term safety of the puncher’s hand and/or the person receiving the strike.Keywords: safety, punching, striking, hitting, combat, pa

Stereotactic Breast Biopsy of Nonpalpable Lesions: Determinants of Ductal Carcinoma in Situ Underestimation Rates

PURPOSE: To measure the effect of biopsy device, probe size, mammographic lesion type, lesion size, and number of samples obtained per lesion on the ductal carcinoma in situ (DCIS) underestimation rate. MATERIALS AND METHODS: Nonpalpable breast lesions at 16 institutions received a histologic diagnosis of DCIS after 14-gauge automated large-core biopsy in 373 lesions and after 14- or 11-gauge directional vacuum-assisted biopsy in 953 lesions. The presence of histopathologic invasive carcinoma was noted at subsequent surgical biopsy. RESULTS: By performing the X2 test, independent significant DCIS underestimation rates by biopsy device were 20.4% (76 of 373) of lesions diagnosed at large-core biopsy and 11.2% (107 of 953) of lesions diagnosed at vacuum-assisted biopsy (P \u3c .001); by lesion type, 24.3% (35 of 144) of masses and 12.5% (148 of 1,182) of microcalcifications (P \u3c .001); and by number of specimens per lesion, 17.5% (88 of 502) with 10 or fewer specimens and 11.5% (92 of 799) with greater than 10 (P \u3c .02). DCIS underestimations increased with lesion size. CONCLUSION: DCIS underestimations were 1.9 times more frequent with masses than with calcifications, 1.8 times more frequent with large-core biopsy than with vacuum-assisted biopsy, and 1.5 times more frequent with 10 or fewer specimens per lesion than with more than 10 specimens per lesion