Recurrent Pregnancy Loss: Investigations and Interventions

Recurrent pregnancy loss (RPL) affects 0.8–1.4% of couples, and this prevalence increases with aging. However, etiology is commonly unknown, and most therapies are not supported by strong evidence. There are many examinations that investigate causes of RPL: hormonal status, spermatozoa morphology and DNA fragmentation, immunologic status, uterine assessment, thrombophilia, and others. Recently different types of treatment have emerged, most lacking good evidence. As for example, we may mention the use of anticoagulants, aspirin, corticosteroids, progesterone, and antioxidants and psychological support. It is argued that some procedures such as preimplantation genetic testing for aneuploidy and intracytoplasmic morphologically selected sperm injection would impact on the outcomes and help RPL management. This chapter will discuss the current evidence concerning examinations and treatments that would improve the outcomes in patients with RPL, with recommended practice

Recurrent Implantation Failure: The Role of Anatomical Causes

Recurrent implantation failure (RIF) is one of the great challenges of current reproductive medicine. The term refers to the failure of repeated transfers of embryos of good morphological quality. Embryo implantation is a crucial moment in in vitro fertilization (IVF) treatments. A successful pregnancy depends on a synchronized interaction between a good quality embryo and a receptive endometrium. Its failure may be a consequence of embryo quality, anatomical or immunological factors. The anatomic causes constitute an important factor for RIF, although they are usually manageable. Fibroids, polyps and adhesions that develop after a surgical procedure or infection can hamper the embryo - endometrium attachment process. In addition, Mullerian abnormalities and hydrosalpinx can cause a negative impact on implantation rates and should also be taken into account in patients with RIF. In this chapter, we will address the main anatomical causes that may impact the implantation rates of patients undergoing IVF, as well as recommendations on management and its treatment

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

A pilot study of topiramate in children with Lennox-Gastaut syndrome Estudo piloto com topiramato em crianças com síndrome de Lennox-Gastaut

We conducted an open, add-on study with topiramate (TPM) as adjunctive therapy in Lennox-Gastaut syndrome (LGS), to assess the long-term efficacy and safety and to evaluate quality of life (QL) measurements in the chronic use of TPM. We studied 19 patients (11 male; age ranging from 4 to 14 years) with uncontrolled seizures receiving 2-3 anti-epileptic drugs. Patients were followed up to 36 months of treatment. A questionnaire was used to query parents about QL. Seven patients completed the study at 36 months and seizure frequency was reduced > 75% in 4, and < 50% in 3 patients. Two children became seizure free for more than 24 months. Most side effects were CNS related, with the most frequent being somnolence and anorexia. These were generally transient. One patient dropped-out due to powder in the urine. None of the patients required hospitalization. At 36 months, patients' alertness (2/7), interaction with environment (5/7), ability to perform daily activities (5/7), and verbal performance (6/7) improved on TPM. We conclude that TPM may be useful as adjunctive therapy in the treatment of LGS. The efficacy of TPM was maintained in long-term treatment in more than 40% of patients, long term safety was confirmed and QL improved on TPM.<br>Realizamos estudo aberto, de adição do topiramato (TPM) como medicação adjuvante no tratamento da síndrome de Lennox-Gastaut (SLG), com a finalidade de verificar a eficácia e a segurança de avaliar a qualidade de vida (QV) no uso crônico do TPM. Estudamos 19 pacientes (11 do sexo masculino; idade entre 4 e 14 anos) com epilepsia de difícil controle e em uso de 2 a 3 drogas anti-epilépticas. Os pacientes foram seguidos por 36 meses. Um questionário foi aplicado aos pais para se avaliar QV. Sete crianças completaram o estudo. A frequência de crises foi reduzida em mais de 75% em 4 e em menos de 50% em 3 delas. Dois pacientes ficaram sem crises. A maioria dos efeitos colaterais relacionou-se ao sistema nervoso central, sendo sonolência e anorexia os mais frequentes e transitórios. Um paciente foi excluído do estudo por apresentar pó na urina. Nenhuma criança necessitou de hospitalização. Aos 36 meses, os pacientes encontravam-se mais alertas (2/7), e houve melhora na interação com o meio ambiente (5/7), na habilidade em realizar tarefas diárias (5/7) e na performance verbal (6/7). Concluímos que o TPM pode ser útil como terapia adjuvante na SLG. A eficácia manteve-se no tratamento a longo prazo em mais de 40% dos pacientes, a segurança foi confirmada e a QV melhorou com o uso do TPM

IAPT chromosome data 31.

POACEAE Paspalum almum Chase, 2n = 12; Argentina, Corrientes, H & D 1703 (MNES), H & D 1704 (MNES).Paspalum conspersum Schrad., 2n = 60; Argentina, Misiones, H & D 1119 (MNES), H & D 1143 (MNES).Paspalum equitans Mez, 2n = 20; Argentina, Misiones, H & D 1447 (MNES).Paspalum fasciculatum Wild. ex Flüggé, 2n = 20; Argentina, Formosa, R 307 (BAA).Paspalum glaucescens Hack., 2n = 40; Argentina, Misiones, H & D 109 (MNES).Paspalum ionanthum Chase, n = 20; Paraguay, Cordillera, H & D 1177 (MNES).Paspalum maculosum Trin., 2n = 20, 40; Argentina, Misiones, H & D 1445 (MNES).Paspalum malacophyllum Trin., 2n = 40; Argentina, Salta, H & D 1448 (MNES).Paspalum notatum var. saurae Parodi, 2n = 20; Argentina, Santa Fe, H & D 1453 (MNES).Paspalum notatum Flüggé var. notatum, 2n = 40; Argentina, Misiones, H 220 (CTES, MNES); Argentina, Santa Fe, H & D 1304 (MNES); Argentina, Misiones, H & D 1603 (MNES).Paspalum pauciciliatum (Parodi) Herter, 2n = 40; Argentina, Misiones, H & D 465 (CTES, MNES).Paspalum paucifolium Swallen, 2n = 40; Paraguay, Paraguarí, H & D 1294 (MNES).Paspalum quarinii Morrone & Zuloaga, 2n = 20; Argentina, Misiones, H & D 1190 (CTES, MNES, SI).Paspalum regnellii Mez, 2n = 40; Argentina, Misiones, H & D 1118 (MNES).Fil: Marhold, Karol. Academia de Ciencias; EslovaquiaFil: Kurĕera, Jaromír. Academia de Ciencias; EslovaquiaFil: Aguiar-Melo, Camila. Universidade Federal do Rio Grande do Sul; BrasilFil: Almeida, Erton Mendonça de. Universidade Estadual da Paraiba; BrasilFil: Alves, Lânia Isis Ferreira. Universidade Estadual da Paraiba; BrasilFil: An'kova, Tatyana V.. Jardin botánico de Siberia Central; RusiaFil: Bered, Fernanda. Universidade Federal do Rio Grande do Sul; BrasilFil: Bonifácio, Kallyne. Universidade Estadual da Paraiba; BrasilFil: Carvalho, Luana. Universidade Federal do Rio Grande do Sul; BrasilFil: Chiarini, Franco Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Cordeiro, Joel M. P.. Universidade Estadual da Paraiba; BrasilFil: Costea, Mihai. Wilfrid Laurier School Of Business; CanadáFil: Daviña, Julio Rubén. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Ebel, Aleksandr L.. Tomsk State University; RusiaFil: Souto, Allan Falconi. Universidad Federal do Abc; BrasilFil: Felix, Cattleya M. P.. Universidade Estadual da Paraiba; BrasilFil: Felix, Leonardo P.. Universidade Estadual da Paraiba; BrasilFil: Fernandez, Aveliano. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: García, Miguel Ángel. University of Toronto; Canadá. Royal Botanic Gardens; Reino UnidoFil: García Ruiz, Ignacio. Instituto Politécnico Nacional. Centro de Investigación y de Estudios Avanzados. Departamento de Física; MéxicoFil: Gil, André dos Santos Bragança. Museu Paraense Emilio Goeldi; BrasilFil: Guerra, Marcelo. Universidade Federal de Pernambuco; BrasilFil: Hirsch, Luiza Domingues. Universidade Federal do Rio Grande do Sul; BrasilFil: Honfi, Ana Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; Argentina. Universidad Nacional de Misiones; ArgentinaFil: Kaltchuk Santos, Eliane. Universidade Federal do Rio Grande do Sul; BrasilFil: Knapp, Sandra. Natural History Museum; Reino UnidoFil: Kumar, Rohit. Punjabi University; IndiaFil: Kumari, Vandna. Punjabi University; IndiaFil: Lovo, Juliana. Instituto Tecnológico Vale. Departamento de Bioinformatica y Genomica Ambiental.; BrasilFil: Lucena, Reinaldo F. P.. Universidade Estadual da Paraiba; BrasilFil: Medeiros Neto, Enoque. Universidade Estadual da Paraiba; BrasilFil: Moraes, Ana Paula. Universidad Federal do Abc; BrasilFil: Nascimento, Rodrigo Garcia Silva. Universidade Estadual da Paraiba; BrasilFil: Neves, José Achilles Lima. Universidade Estadual da Paraiba; BrasilFil: Nollet, Felipe. Universidad Federal Rural Pernambuco; BrasilFil: Oliveira, Regina Célia de. Universidade do Brasília; BrasilFil: Orejuela, Andrés. Royal Botanic Gardens; Reino UnidoFil: Pozzobon, Marisa Toniolo. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; BrasilFil: Reutemann, Anna Verena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Botánica del Nordeste. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botánica del Nordeste; ArgentinaFil: Oliveira Ribeiro, André Rodolfo de. Universidade do Brasília; Brasil. Universidade Estadual do Ceará; BrasilFil: Rua, Gabriel Hugo. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Santos, Angeline M. S.. Universidade Estadual da Paraiba; BrasilFil: Silva, Anádria Stéphanie da. Universidade do Brasília; BrasilFil: Silva, Rosemere. Universidade Estadual da Paraiba; BrasilFil: Silva, Ronimeire Torres da. Universidade Estadual da Paraiba; BrasilFil: Singhal, Vijay Kumar. Punjabi University; IndiaFil: Souza Chies, Tatiana T.. Universidade Federal do Rio Grande do Sul; BrasilFil: Stefanović, Saša. University of Toronto; CanadáFil: Valls, José Francisco Montenegro. Ministerio da Agricultura Pecuaria e Abastecimento de Brasil. Empresa Brasileira de Pesquisa Agropecuaria; Brasil. Universidade do Brasília; BrasilFil: Welker, Cassiano A. D.. Universidade Federal de Uberlandia; BrasilFil: Zykova, Elena. Jardin botánico de Siberia Central; Rusi

Swine and Poultry Pathogens: the Complete Genome Sequences of Two Strains of Mycoplasma hyopneumoniae and a Strain of Mycoplasma synoviae

This work reports the results of analyses of three complete mycoplasma genomes, a pathogenic (7448) and a nonpathogenic (J) strain of the swine pathogen Mycoplasma hyopneumoniae and a strain of the avian pathogen Mycoplasma synoviae; the genome sizes of the three strains were 920,079 bp, 897,405 bp, and 799,476 bp, respectively. These genomes were compared with other sequenced mycoplasma genomes reported in the literature to examine several aspects of mycoplasma evolution. Strain-specific regions, including integrative and conjugal elements, and genome rearrangements and alterations in adhesin sequences were observed in the M. hyopneumoniae strains, and all of these were potentially related to pathogenicity. Genomic comparisons revealed that reduction in genome size implied loss of redundant metabolic pathways, with maintenance of alternative routes in different species. Horizontal gene transfer was consistently observed between M. synoviae and Mycoplasma gallisepticum. Our analyses indicated a likely transfer event of hemagglutinin-coding DNA sequences from M. gallisepticum to M. synoviae