Memory and Longevity Treatments

Via EurekAlert!: "Two methods of extending life span have very different effects on memory performance and decline with age. ... While the nematode C. elegans is already well known for its utility in longevity research, previously it was not known how the memory of C. elegans compares with that of other animals, or whether longevity treatments could improve learning and memory. To answer these questions, [researchers] designed new tests of learning and memory in C. elegans, then used these tests to identify the necessary components of learning, short-term memory, and long-term memory. They found that the molecules required for learning and memory appear to be conserved from C. elegans to mammals, suggesting that the basic mechanisms underlying learning and memory are ancient. The authors also determined how each of the behaviors declines with age, and tested the effects of two known regulators of longevity - dietary restriction and reduced Insulin/IGF-1 signaling - on these declines. Surprisingly, very different effects on memory were achieved with the two longevity treatments: dietary restriction impaired memory in early adulthood but maintained memory with age, while reduced Insulin/IGF-1 signaling improved early adult memory performance but failed to preserve it with age. These results suggest not only that longevity treatments could help preserve cognitive function with age, but also that different longevity treatments might have very different effects on such declines."

View the Article Under Discussion: http://www.eurekalert.org/pub_releases/2010-05/plos-pmw051210.php

Read More Longevity Meme Commentary: http://www.longevitymeme.org/news/

UNBELIEVABLE??

A headline reporting a new Harris Poll survey stated that “Very few Americans find statements by financial institutions completely believable.”  One specific item of interest was that 51 percent of the respondents said that a statement made by someone who works for a health insurance company was believable (2 percent completely believable, 49 percent somewhat believable) while 49 percent answered not at all believable.  Banks, investment firms and government agencies that regulate financial institutions all fared poorly in the believability research. 

These results are not shocking in light of the health care debate and economic stresses that reverberate throughout the economy.  However, the survey shows the depth of the difficulty people have with companies and government agencies that are indispensible to their financial well being. 

This is a good time for intermediaries, whether they are trusted authors, financial advisors, academics and others to fill the void that is obviously missing in the public’s confidence in key industries.  Changes in health care, for example, are sure to cause people to have to rethink sometimes decades old strategies to financing coverage.  The health insurance industry will play a key role in the implementation of health reform, so designing a system in which the public has a basic level of trust is not a trivial matter.

Aspirin May Increase Risk of Crohn’s Disease

Aspirin May Increase Risk of Crohn's Disease

(HealthDay News) -- A new British study finds that people who take aspirin every day have a higher risk of developing Crohn's disease, a potentially devastating digestive illness.

But it's still not very likely that aspirin users will develop the condition, and the study's lead author said patients should keep in mind that aspirin lowers the risk of heart disease.

"If the link with aspirin is a true one, then only a small proportion of those who take aspirin -- approximately one in 2,000 -- may be at risk," said study author Dr. Andrew Hart, a senior lecturer in gastroenterology at University of East Anglia School of Medicine. "If aspirin has been prescribed to people with Crohn's disease or with a family history by their physician, then they should continue to take it. Aspirin has many beneficial effects and should be continued." Read more...

Ayurtox for Body Detoxification

Aspirin May Increase Risk of Crohn's Disease

Aspirin May Increase Risk of Crohn's Disease

(HealthDay News) -- A new British study finds that people who take aspirin every day have a higher risk of developing Crohn's disease, a potentially devastating digestive illness.

But it's still not very likely that aspirin users will develop the condition, and the study's lead author said patients should keep in mind that aspirin lowers the risk of heart disease.

"If the link with aspirin is a true one, then only a small proportion of those who take aspirin -- approximately one in 2,000 -- may be at risk," said study author Dr. Andrew Hart, a senior lecturer in gastroenterology at University of East Anglia School of Medicine. "If aspirin has been prescribed to people with Crohn's disease or with a family history by their physician, then they should continue to take it. Aspirin has many beneficial effects and should be continued." Read more...

Ayurtox for Body Detoxification

7.2% Decrease in Work Hours of U.S. Physicians Between 1996 and 2008

After remaining stable through the early 1990s, mean hours worked per week decreased by 7.2% between 1996 and 2008 among all physicians (from 55 hours per week in 1996-1998 to 51 hours per week in 2006-2008.

Excluding resident physicians, whose hours decreased by 9.8% due to duty hour limits imposed in 2003, nonresident physician hours decreased by 5.7%.

Physician fees decreased nationwide by 25% between 1995 and 2006, coincident with the decrease in physician hours.

A steady decrease in hours worked per week during the last decade was observed for all physicians, which was temporally and geographically associated with lower physician fees.

References:
Trends in the Work Hours of Physicians in the United States, February 24, 2010, Staiger et al. JAMA 303 (8): 747.

From Happy Hospitalist:

"That means your doctor earns 25% less today than they did just a decade ago. If you went to college and joined a company that said up front you would be paid 25% less in a decade than you were paid on the day you were hired, would you join them?

Why are physicians working fewer hours, a trend unique to doctors? The conclusion was reduced pay. Physicians just don't seem inclined to spend long hours in the office and hospitals to sacrifice their family life for the life of their patients when the the economic reward of doing so just isn't there.

I've talked with many subspecialists at Happy's hospital about the declining payment for their efforts. They all tell me exactly the same thing. They are going to work less and limit their hours as payment reductions come down the pipeline."

Image source: sxc.hu

Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook.


FOOX myHeart II and mySkull

David Foox mySkull
Title: “mySkull”
artist: David Foox
medium: acrylic, krylon, on X-Ray (sealed with a kiss) mounted on custom hosital viewing light box
size: 14″ x 22″
David Foox myHeart II
Title: “myHeart II”
artist: David Foox
medium: acrylic, krylon, on X-Ray (sealed with a kiss) mounted on custom dentist viewing light box
size: 12″ x 12″

Two new works by artist and toy maker FOOX and titled “myHeart II” and “mySkull“.

FOOX has taken more X-Rays of himself including an MRI of his skull and all in the name of art. With a solo show “As Within So Without” at Lyons Weir (NY) June 25th through July 17th, FOOX needs all the X-Rays he can get. That’s why he has enlisted the help of yet to be disclosed notable persons.  Can’t wait to find out the identity of these “notable persons!”

Lyons Weir Gallery, New York
“As Within So Without” a Solo Show by David Foox
Curated by Rebecca Marshall
Opening Party: June 25th, 2010 (show through July 17th, 2010)

FOOX continues the awareness campaign promoting organ donation as a cause to help save lives. His ORGAN DONOR vinyl dolls were featured in Kidrobot, Munky King, Zeus Comics, Poptopia, Ultrapop, Super7, and a host of modern art museums. In this exhibition of recent works by David Foox, FOOX shows us his insides – and those of society’s notable and interesting characters. Without disclosing which famous characters’ insides will be painted, FOOX does give us these two sneak peak works recently completed in advance of the opening. Look for more of X-Ray vision by FOOX in the coming months. For more information on FOOX NYC events email Bea bnfoox@gmail.com

Proteus Gowanus Benefit/Anniversary Party, Saturday, May 22nd, 7-10 p.m.

This Saturday May 22, the Morbid Anatomy Library's beloved mother institution Proteus Gowanus will be hosting a benefit party; for the event, I will be on hand to provide wine-soaked tours of the Library and my Observatory exhibition The Secret Museum; there will also be an exciting variety of other events, happenings, workshops, and music, not to mention food and wine. This promises to be a great event! Very much hope to see you there!

Full details follow:

PROTEUS GOWNAUS BENEFIT/ANNIVERSARY CELEBRATION
The Proteus Gowanus Board and Core Collaborators:
Sasha Chavchavadze, Tammy Pittman, Tom LaFarge, Wendy Walker
Julie Freundlich Lang, PK Ramani, Benjamin Warnke, Nick DeFriez
Andrew Beccone, Joanna Ebenstein, David Mahfouda

Invite you to join us for

A Benefit Party
to Celebrate Five Years on the Alleyway

Saturday, May 22nd, 7 - 10 p.m.
RAIN DATE: Sunday, May 23, 7 - 10 p.m.
Featuring

Optiks/Alley
A multimedia installation/performance by Paul Benney and friends
inspired by Newton's Opticks and West Side Story. Viewers will be
transported down the alleyway through a dream-like world
of theatrical lighting, video and an original sound score

And a Laboratory of Protean Workshops:
Rocketworks Countdown 3, a triptych moon launch video
Improvisational Mending with the Fixers Collective: bring a broken object!
Individual and Dual Stunts in the Reanimation Library
A Secret Museum, a private viewing of Morbid Anatomy Library’s collection
The Mysteries of the Gowanus Unveiled in our Hall of the Gowanus
An Oulipian Escapade with our Writhing Society

Music by Union Street Preservation Society
A selection of Thai hors d'oevres by JOYA restaurant
and wine will be served

Tickets $60 each
Space is limited, tickets will be sold
on a first come first served basis

BUY NOW

Or go to http://www.proteusgowanus.com
to buy a ticket or make a donation
718-243-1572
543 Union Street at Nevins Street Gate

You can buy tickets by clicking here; you can find out more about Proteus Gowanus by clicking here, more abou the Morbid Anatomy Library by clicking here, more about Observatory by clicking here, and more about The Secret Museum--which has been extended until June 6th--by clicking here.

Photo: Eric Harvey Brown, for Time Out New York

The Never-Realized Führermuseum, Linz, Austria

Starting in 1939, Nazi henchmen and art dealers bought and stole thousands of paintings, sculptures, tapestries and other objects from private collections across Europe, then stockpiled them. Hitler helped draw up architectural plans, which megomaniacally grew to include a theater and an opera house, a hotel, a library and parade grounds. Photographs show him, pencil in hand, pondering plans and gazing raptly on the model for the site...

Just in time for International Museum Day (which was yesterday, actually!), a fascinating story in the New York Times which details the ill-fated story of Adolf Hitler's never-realized Führermuseum, an art gallery he planned to establish in his hometown of Linz, Austria.

The article details the surprising importance that collecting artworks and planning the architecture and minutia of a museum held for Hitler even up until the eve of his demise; it also traces the history of a series of intruiguing artifacts related to his pursuit: meticulous scrapbooks containing black and white photos of the projected Führermuseum's collection, scrapbooks which now function as a sort of "museum without walls" for this ill-fated museum that never was. The article also provocatively examines in what ways Hitler's projects of collecting and empire might have been linked.

The article explains:

    It’s hard to overstate how seriously [Hitler] took the whole project. Art collecting obsessed him for years; his staff endured nightly soliloquies, Hitler droning on about art while Germany collapsed around him. He fussed even about how the rooms in the museum should be decorated.

    And goes on to comment:

    The jury is out over whether the 'disproportionate amount of time and energy,' as the head of the Allied art-looting investigation unit put it after the war, that Hitler demanded go to amassing art, diverted German resources from the war effort, hastening its end, or the reverse — whether Hitler’s obsession with Linz, and with collecting generally, in some measure motivated him to press on.

    Full story follows; really fascinating stuff, and well worth a read!

    Strange Trip for a Piece of Nazi Past
    By MICHAEL KIMMELMAN

    BERLIN — Robert Edsel, author of “The Monuments Men,” came to town the other day with a heavy album bound in green Moroccan leather. “Gemäldegalerie Linz XIII” was embossed on the spine. Inside were black-and-white photographs of mostly obscure 19th-century German paintings.

    The album was one of the long-missing volumes cataloging the never-built Führermuseum in Linz, Austria, which Hitler envisioned someday rivaling Dresden and Munich. Starting in 1939, Nazi henchmen and art dealers bought and stole thousands of paintings, sculptures, tapestries and other objects from private collections across Europe, then stockpiled them. Hitler helped draw up architectural plans, which megomaniacally grew to include a theater and an opera house, a hotel, a library and parade grounds. Photographs show him, pencil in hand, pondering plans and gazing raptly on the model for the site.

    “And so they are ever returning to us, the dead,” the German novelist W. G. Sebald wrote in “The Emigrants.” “At times they come back from the ice more than seven decades later and are found at the edge of the moraine, a few polished bones and a pair of hobnailed boots.” He was recalling a long-forgotten Alpine climber, whose remains a glacier in Switzerland suddenly released, 72 years after the man had gone missing.

    But really Sebald was describing the past, which everywhere turns up unexpectedly, jolting us from our historical amnesia. A German publisher, Berliner Verlag, just released a book of photographs of postwar Berlin that had somehow languished in its archives. I know a man in Spain who has been accumulating long-forgotten photographs and other private relics from the war: a mesmerizing and mysterious stash of soldiers’ snapshots and letters, and documents scrawled with Hitler’s notes. The missing Linz album surfaced not long ago outside Cleveland, of all places. An 88-year-old veteran, John Pistone, who fought with Patton’s army, picked it up in 1945 while rummaging through the Berghof, Hitler’s retreat in the Bavarian Alps. Like other soldiers, he wanted a souvenir to prove he’d been there. He didn’t know, or particularly care, what the album was, and only learned its significance when a contractor installing a washer-dryer in his house noticed the volume on a shelf, hunted for information via the Internet, then called Mr. Edsel.

    Mr. Edsel heads the Monuments Men Foundation for the Preservation of Art, an organization dedicated to preserving the legacy of the 350 or so Allied soldiers tasked with looking after cultural treasures in Europe. A 53-year-old, white-haired former oilman, Mr. Edsel isn’t the sort of person who takes no for an answer, and he persuaded Mr. Pistone to relinquish the volume to the German Historical Museum in Berlin , which has the other extant Linz albums. (This makes 20; 11 are still missing.)

    Hitler was presented with the albums every Christmas and on his birthday. They featured reproductions of the latest art to go into the museum. The books were a virtual museum-in-waiting, a museum without walls. You imagine him cradling the bulky volumes, ogling bucolic scenes of a bygone German countryside now in ruins, imagining himself the next Medici.

    It’s hard to overstate how seriously he took the whole project. Art collecting obsessed him for years; his staff endured nightly soliloquies, Hitler droning on about art while Germany collapsed around him. He fussed even about how the rooms in the museum should be decorated.

    “I never bought the paintings that are in the collections that I built up over the years for my own benefit,” he took pains to write in his brief will, just before putting a pistol to his head, “but only for the establishment of a gallery in my hometown of Linz.”

    A model of Linz had already been moved to the bunker in Berlin so it would be among the last things he saw.

    Volume XIII, Mr. Pistone’s album, contains reproductions of 19th-century German and Austrian pictures, the art Hitler admired most. He may have bought some of these works with royalties from “Mein Kampf.” They’re mawkish idylls by painters largely obscure even to Germans and Austrians today. The best pictures are by Adolph von Menzel and Hans Makart, with whose early underappreciation Hitler perversely identified.

    Time whitewashes evil, or not. Mr. Edsel expressed his opinion this week that more and more curios like Mr. Pistone’s album would surface now that the last surviving veterans are dying.

    “Emotional value doesn’t transfer across generations,” is how he put it. “People don’t inherit passions.” One man’s private memento becomes another’s opportunity to sell something on eBay, notwithstanding that German and American authorities insist that artifacts like the Linz album are cultural property that shouldn’t be sold. Regardless, he meant that in the process of passing between generations, the object gains new life.

    In a ceremony on Tuesday, Volume XIII was delivered to the German Historical Museum here, joining other Linz albums on display behind glass, like contaminated evidence. The jury is out over whether the “disproportionate amount of time and energy,” as the head of the Allied art-looting investigation unit put it after the war, that Hitler demanded go to amassing art, diverted German resources from the war effort, hastening its end, or the reverse — whether Hitler’s
    obsession with Linz, and with collecting generally, in some measure motivated him to press on.

    Historians can thrash that out. Meanwhile, there are the 11 unaccounted-for albums. Presumably they’re still out there, like Sebald’s polished bones.

    You can view the full article by clicking here, and see the related slide-show--from which the above image, captioned "Hitler at work on plans for his museum in Linz, Austria," was drawn-- by clicking here.

    Aspirin May Increase Risk of Crohn’s Disease

    Aspirin May Increase Risk of Crohn's Disease

    (HealthDay News) -- A new British study finds that people who take aspirin every day have a higher risk of developing Crohn's disease, a potentially devastating digestive illness.

    But it's still not very likely that aspirin users will develop the condition, and the study's lead author said patients should keep in mind that aspirin lowers the risk of heart disease.

    "If the link with aspirin is a true one, then only a small proportion of those who take aspirin -- approximately one in 2,000 -- may be at risk," said study author Dr. Andrew Hart, a senior lecturer in gastroenterology at University of East Anglia School of Medicine. "If aspirin has been prescribed to people with Crohn's disease or with a family history by their physician, then they should continue to take it. Aspirin has many beneficial effects and should be continued." Read more...

    Ayurtox for Body Detoxification

    Is human fecundity declining in Western countries?

    Since Carlsen and co-workers reported in 1992 that sperm counts have decreased during the second half of the last century in Western societies, there has been widespread anxiety about the adverse effects of environmental pollutants on human fecundity. The Carlsen report was followed by several re-analyses of their data set and by many studies on time trends in sperm quality and on secular trends in fecundity. However, the results of these studies were diverse, complex, difficult to interpret and, therefore, less straightforward than the Carlsen report suggested. The claims that population fecundity is declining and that environmental pollutants are involved, can neither be confirmed nor rejected, in our opinion. However, it is of great importance to find out because the possible influence of widespread environmental pollution, which would adversely affect human reproduction, should be a matter of great concern triggering large-scale studies into its causes and possibilities for prevention. The fundamental reason we still do not know whether population fecundity is declining is the lack of an appropriate surveillance system. Is such a system possible? In our opinion, determining total sperm counts (as a measure of male reproductive health) in combination with time to pregnancy (as a measure of couple fecundity) in carefully selected populations is a feasible option for such a monitoring system. If we want to find out whether or not population fecundity will be declining within the following 20–30 years, we must start monitoring now.

    Avoiding transgenerational risks of mitochondrial DNA disorders: a morally acceptable reason for sex selection?

    In this article, we discuss sex selection not intended to help a couple avoid having a child with a severe genetic disorder, but to avoid possible health risks further along the line of generations. Sex selection may be put to this use in the context of preventing mitochondrial DNA disorders by means of preimplantation genetic diagnosis (PGD) and possibly in the future also through nuclear transfer (NT; also known as mitochondrial gene replacement). A relevant analogy can be found in the context of PGD for X-linked diseases, where sex selection against healthy female carrier embryos would have the same 2-fold purpose of (i) avoiding difficult reproductive decisions for the future child and (ii) avoiding transmission of the mutation to a possible third generation. Because sex selection would still be done for reasons of health, this application should not give rise to the moral concerns associated with sex selection for non-medical reasons. However, the proportionality of adding the relevant procedures to PGD or NT is a relevant concern. We discuss post- and preconceptional sex selection strategies. We conclude that if PGD is already part of the procedure, either as the central technology or as a back-up test after NT, preferentially transferring male embryos could in principle be a morally acceptable way of reducing possible burdens and risks. To start an IVF/PGD-cycle especially for this purpose would be disproportional. The alternative approach of preconceptional sex selection may be morally justified as a means to increase the chances of obtaining male embryos.

    Cross border reproductive care in six European countries

    BACKGROUND

    The quantity and the reasons for seeking cross border reproductive care are unknown. The present article provides a picture of this activity in six selected European countries receiving patients.

    METHODS

    Data were collected from 46 ART centres, participating voluntarily in six European countries receiving cross border patients. All treated patients treated in these centres during one calendar month filled out an individual questionnaire containing their major socio-demographic characteristics, the treatment sought and their reasons for seeking treatment outside their country of residence.

    RESULTS

    In total, 1230 forms were obtained from the six countries: 29.7% from Belgium, 20.5% from Czech Republic, 12.5% from Denmark, 5.3% from Slovenia, 15.7% from Spain and 16.3% from Switzerland. Patients originated from 49 different countries. Among the cross border patients participating, almost two-thirds came from four countries: Italy (31.8%), Germany (14.4%), The Netherlands (12.1%) and France (8.7%). The mean age of the participants was 37.3 years for all countries (range 21–51 years), 69.9% were married and 90% were heterosexual. Their reasons for crossing international borders for treatment varied by countries of origin: legal reasons were predominant for patients travelling from Italy (70.6%), Germany (80.2%), France (64.5%), Norway (71.6%) and Sweden (56.6%). Better access to treatment than in country of origin was more often noted for UK patients (34.0%) than for other nationalities. Quality was an important factor for patients from most countries.

    CONCLUSIONS

    The cross border phenomenon is now well entrenched. The data show that many patients travel to evade restrictive legislation in their own country, and that support from their home health providers is variable. There may be a need for professional societies to establish standards for cross border reproductive care.

    Morphometric dimensions of the human sperm head depend on the staining method used

    BACKGROUND

    Assessment of sperm morphology (including morphometry) is extensively used to determine one of the qualities of a semen sample and depends on the differential staining of spermatozoa. A staining technique should cause as little change to sperm dimensions and form as possible in order to reliably evaluate the morphometric features of the sperm. Various staining techniques have been employed, but only a few have been recommended by the World Health Organization and are amenable to automated sperm morphometry analysis. Our study was aimed at comparing the effect of three staining techniques [Papanicolaou (PAP), Rapidiff® (RD) and SpermBlue® (SB)] on human sperm head dimensions and to compare these with the head dimensions in fresh semen.

    METHODS

    Smears made from human semen samples (n = 24) were stained according to the three staining techniques and sperm head morphometry was assessed with the Sperm Class Analyzer. Head dimensions of fresh spermatozoa were measured with a digital calliper on a computer screen. The minimum number of spermatozoa to be analyzed to represent the sperm population and the degree of inter-laboratory variation were determined. Electron micrographs from the same semen samples were used to determine the actual acrosome coverage of the spermatozoa in the semen (n = 7) in order to verify the results of the automatic analyses.

    RESULTS

    The osmolality of human semen differs from that of the RD and PAP fixatives and stains, but is more similar to the SB fixative and stain. At least 100 spermatozoa should be analyzed to include a representative sample of the sperm population. RD caused sperm heads to swell, PAP caused them to shrink and SB had no significant effect on sperm head dimensions when compared with spermatozoa in fresh semen. Very little inter-laboratory variations were found. The percentage acrosome coverage was significantly different between the three staining techniques, as well as between the RD and PAP stains and the manual measurements obtained using the electron micrographs.

    CONCLUSIONS

    Different staining techniques change the morphometric dimensions of the human sperm head, probably due to the fact that either the fixatives or stains are not iso-osmotic in relation to human semen. Since these changes in sperm head dimensions are not uniform, care should be taken when selecting a staining technique. Ideally, stained spermatozoa should have dimensions as close to spermatozoa in fresh semen as possible, as was found with the SB staining method, resulting in accurate evaluations of sperm head morphometry.

    ESX1 gene expression as a robust marker of residual spermatogenesis in azoospermic men

    BACKGROUND

    It would be of value to identify ongoing spermatogenesis molecular markers which can predict successful sperm recovery in patients with non-obstructive azoospermia undergoing conventional or microsurgical testicular sperm extraction (TESE/microTESE). ESX1 is an X-linked homeobox gene expressed in testis, placenta, brain and lung in humans and specifically in pre- and post-meiotic germ cells of the testis in mice.

    METHODS

    We investigated the sequence, expression (by RT–PCR) and epigenetic status (by promoter pyrosequencing) of ESX1 in testicular tissue samples, obtained from 81 azoospermic subjects in the context of surgical sperm extraction, to check a possible association between ESX1 alterations and impaired spermatogenesis, as determined by histological analysis.

    RESULTS

    The ESX1 transcript was detected in 100% of cases diagnosed as obstructive azoospermia (33), hypospermatogenesis (18) and incomplete maturation arrest (MA) (2), and sperm recovery was also successful in 100% of these cases. ESX1 mRNA was also detected in 5 of 6 patients with incomplete Sertoli cell-only syndrome, in 4 of 6 subjects with complete MA but in only 3 of 16 cases of complete Sertoli cell-only syndrome (cSCOS), whereas sperm recovery was successful in 4 of 6, 2 of 6 and 5 of 16 of these patients, respectively. In cases of focal spermatogenesis, ESX1 expression and sperm retrieval were concordant in 14 of 19 (74%) cases subjected to TESE, but in only 3 of 11 (27%) men who underwent microTESE. With TESE, but not with microTESE, both samples originated from adjacent testicular areas. The pyrosequencing of the ESX1 CpG island revealed methylation levels that were significantly lower in ESX1 expressors when compared with non-expressors.

    CONCLUSIONS

    ESX1 emerges as a potentially reliable spermatogenesis molecular marker, whose clinical value as a predictor of successful sperm retrieval warrants further studies.

    Innovative virtual reality measurements for embryonic growth and development

    BACKGROUND

    Innovative imaging techniques, using up-to-date ultrasonic equipment, necessitate specific biometry. The aim of our study was to test the possibility of detailed human embryonic biometry using a virtual reality (VR) technique.

    METHODS

    In a longitudinal study, three-dimensional (3D) measurements were performed from 6 to 14 weeks gestational age in 32 pregnancies (n = 16 spontaneous conception, n = 16 IVF/ICSI). A total of 125 3D volumes were analysed in the I-Space VR system, which allows binocular depth perception, providing a realistic 3D illusion. Crown-rump length (CRL), biparietal diameter (BPD), occipito-frontal diameter (OFD), head circumference (HC) and abdominal circumference (AC) were measured as well as arm length, shoulder width, elbow width, hip width and knee width.

    RESULTS

    CRL, BPD, OFD and HC could be measured in more than 96% of patients, and AC in 78%. Shoulder width, elbow width, hip width and knee width could be measured in more than 95% of cases, and arm length in 82% of cases. Growth curves were constructed for all variables. Ear and foot measurements were only possible beyond 9 weeks gestation.

    CONCLUSIONS

    This study provides a detailed, longitudinal description of normal human embryonic growth, facilitated by a VR system. Growth curves were created for embryonic biometry of the CRL, BPD, HC and AC early in pregnancy and also of several ‘new’ biometric measurements. Applying virtual embryoscopy will enable us to diagnose growth and/or developmental delay earlier and more accurately. This is especially important for pregnancies at risk of severe complications, such as recurrent late miscarriage and early growth restriction.

    Consecutive or non-consecutive recurrent miscarriage: is there any difference in carrier status?

    BACKGROUND

    Carrier status of a structural balanced chromosome abnormality is associated with recurrent miscarriage. There is, at present, no evidence of the impact of the sequence of preceding pregnancies on the probability of carrier status. The aim of our study was therefore to examine whether the history of consecutive versus non-consecutive miscarriages in couples with two or more miscarriages has any impact on the probability of carrying a chromosome abnormality.

    METHODS

    A nested case–control study was performed in six centres for clinical genetics in the Netherlands. Couples referred for chromosome analysis after two or more miscarriages were included: 279 couples with a carrier of a structural chromosomal abnormality and 428 non-carrier couples who served as controls. Univariable and multivariable logistic regression analyses, corrected for known risk factors for carrier status, were performed. The main outcome measure was the probability of carrier status.

    RESULTS

    Two hundred and fifty-six of 279 (92%) carrier couples and 381 of 428 (89%) non-carrier couples had experienced consecutive miscarriages (P = 0.21). A history of two or three consecutive miscarriages did not alter the probability of carrier status when compared with two [odds ratio (OR) 0.90, 95% confidence interval (CI) 0.48–1.7] or three (OR 0.71, 95% CI 0.39–1.3) non-consecutive miscarriages.

    CONCLUSIONS

    The sequence of preceding pregnancies is not a risk factor for carrier status. Therefore, couples with miscarriages interspersed with healthy child(ren) should be managed the same as couples with consecutive miscarriages regarding chromosome diagnosis.

    A longitudinal study of contraception and pregnancies in the same women followed for a quarter of a century

    BACKGROUND

    There is a need to improve our understanding of contraceptive use over the long term. The aims of this study were to describe contraceptive use and pregnancies in the same women followed prospectively from 19 to 44 years of age.

    METHODS

    In 1981, a postal questionnaire about contraception, pregnancies and reproductive health was sent to a random sample (n = 656) of 19-year-old women resident in Gothenburg, Sweden. The responders were contacted again every fifth year.

    RESULTS

    At 19 years of age, 74% of the women had already used contraception and this increased to 98% at 44 years. Combined oral contraception was the commonest method currently used up to 29 years of age (48/51/22% at 19/24/29 years of age, respectively) and thereafter an intrauterine device (IUD: 34/39/38% at 34/39/44 years of age, respectively). Condom use alone during the 25-year study period was: 14/12/24/21/21/15% and non-use of contraception was: 35/24/26/20/21/26%. The mean number of pregnancies/children increased from 0.2/0.1 at 19 years of age to 3.1/2.1 at 44 years. Women who had been pregnant and women who had not been pregnant ≤19 years of age were compared up to 44 years of age (months of OC use: 69/107, P < 0.01; months of IUD use: 126/91, P < 0.01; 4.2/2.9 pregnancies, P < 0.001; 2.5/2.1 children, P< 0.09).

    CONCLUSIONS

    Choice of contraception was strongly related to age and parity, and the cumulative total number of pregnancies at 44 years of age, and contraceptive choice was related to age at first pregnancy.

    Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system

    BACKGROUND

    Consecutive use of the levonorgestrel-releasing intrauterine system (LNG-IUS) is increasing. However, little is known about factors that predict the bleeding during consecutive use. The objective of this study was to analyse the possible factors which may predict the bleeding pattern during the first year of use of a second LNG-IUS.

    METHODS

    Fertile-aged women (n = 204) who had used their first LNG-IUS for over 4 years and who opted for a second LNG-IUS were recruited. Bleeding data were reported using 90-day reference periods (RPs) starting from the last 90 days of the first LNG-IUS use (baseline), until the end of the first year of the second LNG-IUS (RPs 1–4).

    RESULTS

    Demographic factors such as age, parity, body mass index, indication of LNG-IUS use or smoking could not be identified as predictors for bleeding and spotting (B/S). Mean (±SD) number of B/S days was 8.9 (±9.1) at baseline. This increased slightly during RP1 and fell to 6.4 (±8.1) during RP4. Compared with the mean, women with uterine fibroids or a bleeding pattern of >9 days of spotting or any bleeding at RP1 had more B/S days during RP1–4. Although the number of B/S days decreased progressively from RP1 to RP4 in the group with a bleeding pattern of >9 days of spotting or any bleeding at baseline, such a phenomenon was not observed for women with fibroids. The difference for the change in B/S days between women with and without fibroids was statistically significant at RP3 and RP4. A high degree (91.7%) of satisfaction with the bleeding pattern was observed, with amenorrhoeic women being most satisfied.

    CONCLUSIONS

    Uterine B/S is reduced during consecutive use of the LNG-IUS. Women with uterine fibroids or any bleeding at baseline continued to have more B/S than other women.

    Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas

    BACKGROUND

    The aim of this study was to estimate whether or not the size of an endometrioma is related to the thickness of the ovarian parenchyma inadvertently excised along with the cyst wall.

    METHODS

    We performed a retrospective study including 35 women who had undergone endometrioma cystectomy, using an ovarian tissue sparing procedure. In total 38 specimens were studied by three pathologists as three women presented bilateral localizations, and all cyst diameters measured at least 30 mm. For each endometrioma, serial sections were performed, and on each section four different sites were randomly chosen to measure the thickness of glandular epithelium and stroma, of subjacent fibrosis, depending on the cyst, and of the ovarian parenchyma removed with the cyst. The diameter of the ovary was measured preoperatively either by MRI or ultrasound, and the area of the internal wall was then calculated. The relationships between the mean thickness of ovarian parenchyma removed and the variables were estimated and a multiple regression model identified independent predictors for ovarian parenchyma thickness.

    RESULTS

    Adjacent ovarian tissue was found in 37 cases (97%). The mean thickness of ovarian tissue removed was 1173 ± 711 µm and that of the cyst wall was 851 ± 499 µm. The thickness of the ovarian parenchyma removed presented a direct proportional relationship with cyst diameter (P = 0.015), and consequently with cyst wall area (P = 0.032). This relationship with cyst diameter was independent after adjustment on other variables (P = 0.032).

    CONCLUSION

    Endometrioma cystectomy even though performed with an accurate surgical technique leads to significant ovarian tissue removal, the thickness of which increases proportionally with cyst diameter.

    Large prospective, pregnancy and infant follow-up trial assures the health of 1000 fetuses conceived after treatment with the GnRH antagonist ganirelix during controlled ovarian stimulation

    BACKGROUND

    A concern for new compounds in fertility treatment is the possible risk of perinatal complications or birth defects. To demonstrate long-term safety of ganirelix (GnRH antagonist) treatment in controlled ovarian stimulation (COS), follow-up data on pregnancy and neonatal outcome were analysed for 1000 fetuses (≥16 gestational weeks).

    METHODS

    Obstetrical and neonatal data on 839 pregnancies, resulting in 969 live born infants after ganirelix treatment were compared with a historical cohort of 753 pregnancies after long GnRH agonist (buserelin) treatment, resulting in 963 live born infants. All treatment cycles were performed in a single fertility centre. The infants were examined at the Universitair Ziekenhuis Brussel using an identical follow-up protocol. Incidence of major malformations (i.e. causing functional impairment or requiring surgical correction) was the primary end-point and was analysed by logistic regression including treatment, age of mother, IVF method and pregnancy type (singleton/multiple) as independent variables.

    RESULTS

    There were no relevant differences in maternal characteristics, fertilization method and pregnancy and delivery complications between the ganirelix and historical GnRH agonist groups. There were relatively more multiple pregnancies in the historical GnRH agonist group (31.9%) than the ganirelix group (18.7%; P < 0.0001). The groups were comparable with respect to pregnancy loss after 16 weeks gestation. The incidence of major congenital malformations in fetuses with gestational age ≥26 weeks was 5.0% in the ganirelix cohort versus 5.4% in the historical GnRH agonist group (odds ratio 0.94, 95% confidence interval, 0.62–1.42).

    CONCLUSION

    In terms of neonatal outcome and risk of major malformations, treatment with the GnRH antagonist ganirelix during COS is as safe as traditional GnRH agonists.

    ClinicalTrials.gov identifier NCT00724789.