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Surgical and nutritional interventions for endometrial receptivity:A case report and review of literature

World Journal of Clinical Cases 2022年第33期10卷 12295-12304页

作者： Dinorah Hernández-Melchor Cecilia Palafox-Gómez Ivan Madrazo Ginna Ortiz America Padilla-Viveros esther lópez-bayghen Science Technology and Society ProgramCentro de Investigación y de Estudios Avanzados del Instituto Politécnico NacionalMéxico City 07360CDMXMéxico Clinical Research Instituto Regenera SCMéxico City 05320CDMXMéxico Departamento de Toxicología Centro de Investigación y de Estudios Avanzados del Instituto Politécnico NacionalMéxico City 07360CDMXMéxico Investigación Clínica Instituto de Infertilidad y Genética México SCINGENESMéxico City 05320CDMXMéxico Departamento de Toxicología Centro de Investigación y de Estudios Avanzados del Instituto Politécnico NacionalMexico City 07360CDMXMéxico

BACKGROUND Polycystic ovary syndrome(PCOS)is an endocrine disease that combines metabolic,reproductive,and psychological dysfunctions.Ovulation disorders and impaired endometrial receptivity in PCOS can cause infertility.Insulin resistance(IR)is a pathological state of inadequate response to insulin that affects reproduction in PCOS,as damage caused by IR at the endometrial level becomes an obstacle for embryo implantation.Reversing IR resulted in spontaneous pregnancies in PCOS patients,indicating that metabolic corrections improve endometrial dysfunctions.Mesenchymal stem-cell treatment has also corrected endometrial quality and lead to pregnancies in patients with Asherman’s syndrome.We propose a combination of nutritional intervention with the surgical placement of stem cells to improve endometrial quality to achieve pregnancy in a PCOS patient undergoing in vitro fertilization(IVF)treatment.CASE SUMMARY After two failed IVF cycles,a metabolic intervention,consisting of a ketogenic diet with daily consumption of 50 g of carbohydrates(CH),was indicated until pregnancy.Metabolic Syndrome was assessed using the Harmonizing Definition(3 of 5 pathologies:Central obesity,hypertension,hyperglycemia,hypertriglyceridemia,and dyslipidemia),and the Homeostatic Model Assessment of IR(HOMA-IR)was used to measure the level of IR.Once IR improved,endometrial quality improved.However,two day 5-thawed embryos(euploid,donated oocyte–partner's sperm)failed to implant,suggesting endometrial quality improvement was insufficient.Therefore,transmyometrial implantation of mesenchymal stem cells from the stromal vascular fraction of adipose tissue was performed to enrich the endometrial stem cell niche.Minimal endometrial mean thickness for embryo transfer(6.9 mm)was achieved three months after stem cell treatment and continuous dietary control of IR.Two euploid-day 5-thawed embryos(donated oocyte–partner's sperm)were transferred,and embryo implantation was confirmed on day 14 byβ-hCG serum levels.Currently,a 37 wk baby girl is born.

关键词： Polycystic ovarian syndrome Insulin resistance Nutritional intervention Endometrial quality Stem cell treatment Case report

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Successful treatment with hysteroscopy for infertility due to isthmocele and hydrometra secondary to cesarean section: A case report

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World Journal of Clinical Cases 2019年第6期7卷 753-758页

作者： luis Pablo lópez Rivero Miguel Jaimes Felipe Camargo esther lópez-bayghen Instituto de Infertilidad y Genética México SC Departamento de Toxicología Centro de Investigación de Estudios

BACKGROUND An isthmocele is a scar defect in the uterine wall due to a cesarean section. Its prevalence is unknown,but it has been associated with secondary infertility.Here,we present a case where the patient suffered from an isthmocele that was associated with persistent hydrometra,which developed during in vitro fertilization.CASE SUMMARY The patient underwent hysteroscopic surgery,which successfully resolved the isthmocele as well as the hydrometra. Afterward,two high-quality,euploid embryos,determined by morphological assessment and pre-implantation genetic diagnostic testing,were transferred. This resulted in uterine pregnancy,as determined byserum β-human chorionic gonadotropin levels on day 14(180 m U/ml) and ultrasound-confirmed presence of a gestational sac with a positive embryocardia at week 6. The pregnancy reached 36 wk without any complications,and the product was born in good health. We report a successful isthmocele treatment in a patient with secondary infertility,in which the isthmocele was the cause of persistent hydrometra.CONClUSION Hydrometra caused by secondary cesarean is an infertility factor,which can be corrected by hysteroscopy plus ablation of the isthmocele.

关键词： In vitro fertilization Isthmocele Hydrometra Case report

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loculated pericardial hematoma diagnosed with point-of-care ultrasound

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World Journal of Emergency Medicine 2024年第3期15卷 241-242页

作者： Joaquín Valle Alonso esther Montoro leandro Noblia Emergency Department Royal Bournemouth HospitalBournemouth 14450UK Emergency Department Hospital Santa LuciaCartagena 30202Spain

Pericardial hematoma is a rare but potentially lifethreatening consequence following cardiac surgery that requires prompt recognition and intervention.Patients can present with symptoms such as chest pain,dyspnea,tachycardia,and hypotension,which may mimic other post-operative issues.loculated pericardial hematoma compressing the atria might be difficult to diagnose.Bleeding and hematoma are more common in patients receiving early anticoagulant therapy.A focused cardiac ultrasound (Fo CUS) plays a pivotal role in the diagnosis,revealing the presence of pericardial effusion and signs of cardiac compression.The aim of this report was to provide a prompt diagnosis of loculated pericardial hematoma via Fo CUS in the emergency department (ED).

关键词： hematoma diagnosis cardiac

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Whole-genome amplification/preimplantation genetic testing for propionic acidemia of successful pregnancy in an obligate carrier Mexican couple:A case report

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World Journal of Clinical Cases 2021年第29期9卷 8797-8803页

作者： Adina Neumann Miguel Angel Alcantara-Ortigoza Ariadna González-del Angel Nestor Alejandro Zarate Díaz Javier Sam Santana leonardo M Porchia esther lópez-bayghen laboratorio de Investigación y Diagnóstico Molecular IngenesMexico City 05320Mexico laboratorio de Biología Molecular Subdirección de Investigación MédicaInstituto Nacional de PediatríaMexico City 04530Mexico DNA-GEN S.C.Centro de Alta Especialidad en Genética Humana Mexico City 14070Mexico Investigación Clínica IngenesPuebla 72820Mexico Departamento de Toxicología Centro de Investigación y de Estudios Avanzados del Instituto Politécnico NacionalMexico City 07360Mexico

BACKGROUND Identifying a potential single monogenetic disorder in healthy couples is costly due to the Assisted Reproduction facilities'current methodology for screening,which focuses on the detecting multiple genetic disorders at once.Here,we report the successful application of a low-cost and fast preimplantation genetic testing for monogenic/single gene defects(PGT-M)approach for detecting propionic acidemia(PA)in embryos obtained from a confirmed heterozygous propionyl-CoA carboxylase alpha subunit(PCCA)couple.CASE SUMMARY A fertile 32-years old Mexican couple with denied consanguinity sought antenatal genetic counseling.They were suspected obligate PA carriers due to a previous deceased PA male newborn with an unknown PCCA/propionyl-CoA carboxylase beta subunit(PCCB)genotype.Next-Generation Sequencing revealed a heterozygous genotype for a pathogenic PCCA variant(c.2041-1G>T,ClinVar:RCV-000802701.1;dbSNP:rs1367867218)in both parents.The couple requested in vitro fertilization(IVF)and PGT-M for PA.From IVF,12 oocytes were collected and fertilized,of which two resulted in high-quality embryos.Trophectoderm biopsies and Whole Genome Amplification by a fragmentation/amplification-based method were performed and revealed that the two embryos were euploid.Endpoint polymerase chain reaction and further Sanger sequencing of the exon-intron borders revealed a wild-type PCCA male embryo and a heterozygous c.2041-1G>T female embryo.Both embryos were transferred,resulting in a clinical pregnancy and the delivery of a healthy male newborn(38 wk,weight:4080 g,length:49 cm,APGAR 9/9).The absence of PA was confirmed by expanded newborn screening.CONClUSION We show that using PGT-M with Whole Genome Amplification templates,coupled with IVF,can reduce the transmission of a pathogenic variant of the PCCA gene.

关键词： Propionic acidemia Autosomal recessive Propionyl-CoA carboxylase alpha subunit(PCCA)gene Preimplantation genetic testing Next-generation sequencing Embryo transfer

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Mid-term survival of the Optimys short stem: A prospective case series of 500 patients

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World Journal of Orthopedics 2024年第3期15卷 257-265页

作者： Bryan Hamans Sheryl de Waard Sjoerd Kaarsemaker esther R C Janssen Inger N Sierevelt Gino M M J Kerkhoffs Daniël Haverkamp Department of Orthopaedic Surgery Xpert ClinicAmsterdam 1101EANetherlands Department of Orthopedic Surgery Amsterdam University Medical CenterAmsterdam 1105 AZNetherlands esther R C Janssen Department of Orthopaedic SurgeryViecuri Medisch CentrumVenlo 5912 BLNetherlands Centre for Orthopaedic Research Spaarne ZiekenhuisHoofddorp 2134 TMNetherlands Department of Orthopaedic Surgery and Sports Medicine Amsterdam UMC-Location AMCAmsterdam 1105 AZNetherlands Department of Orthopedic Surgery Xpert Orthopedic Surgery ClinicAmsterdam 1101 EANetherlands

BACKGROUND In recent years,there has been an increase in the number of total hip arthroplasty procedures in the younger patient population.This active group has higher expectations of their prosthesis in comparison to the older population,and there is a greater physical demand for the prosthesis.Short femoral stems were in-troduced to retain proximal bone stock and joint biomechanics and became more common to implant in this specific population.Currently,the long-term survival and functional outcomes of various short stems are still being investigated in different clinics.AIM To determine the 5-year survival of the Optimys hip stem.METHODS This was a prospective multicenter cohort study of 500 patients conducted in two hospitals in the Netherlands.All patients received the Optimys short stem(Mathys ltd,Bettlach,Switzerland).The primary outcome measure was survival of the hip stem,with revision as the endpoint.The secondary outcome measurements included patient-reported outcome measures(PROMs).Kaplan-Meier analysis was used to calculate the 5-year survival rate.log-minus-log transformation was performed to calculate the 95%confidence interval(95%CI).Mixed model analyses were performed to assess the course of the PROMs during the 1st 2 years after surgery.Analyses were modeled separately for the 1st and 2nd years to calculate the yearly change in PROMs during both follow-up periods with accompanying 95%CIs.RESUlTS The mean age of the total 500 patients was 62.3 years(standard deviation:10.6)and 202 were male(40%).At a median follow-up of 5.5 years(interquartile range:4.5-6.7),7 patients were deceased and 6 revisions were registered,for infection(n=3),subsidence(n=2)and malposition(n=1).This resulted in an overall 5-year survival of 98.8%(95%CI:97.3-99.5).If infection was left out as reason for revision,a stem survival of 99.4%(95%CI:98.1-99.8)was seen.Baseline questionnaires were completed by 471 patients(94%),317 patients(63%)completed the 1-year follow-up questionnaires and 233 patients(47%)completed the 2-year f

关键词： Total hip arthroplasty Femoral stem Short stem Optimys Survival 5-year survival Revision PROMs

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Are school uniforms associated with gender inequalities in physical activity? A pooled analysis of population-level data from 135 countries/regions

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Journal of Sport and Health Science 2024年第4期13卷 590-598页

作者： Mairead Ryan luiza I.C.Ricardo Nicole Nathan Riikka Hofmann esther van Sluijs Medical Research Council Epidemiology Unit University of CambridgeCambridge CB20QQUK Faculty of Education University of CambridgeCambridge CB28PQUK Hunter New England Population Health WallsendNSW 2287Australia School of Medicine and Public Health College of HealthMedicine and WellbeingUniversity of NewcastleCallaghanNSW 2308Australia Hunter Medical Research Institute New Lambton HeightsNSW 2305Australia National Centre of Implementation Science University of NewcastleCallaghanNSW 2308Australia

Purpose:It is aimed to assess whether school uniforms are associated with population-level gender inequalities in physical activity,and whether associations differ by school level,country/region income,and assessment method.Methods:An ecological study design was employed.We collected data about global uniform practices using an online survey.We searched for country/region-level estimates of school-aged youth meeting physical activity guidelines from international surveillance studies.Study selection was conducted in duplicate using a systematic process,and a random sample of all data was checked to ensure extraction and pooling processes were accurate.We calculated absolute and relative gender inequalities in physical activity for each country.linear regression examined associations between country/region-level uniform practices(binary yes/no exposure variable)and country/region-level gender inequalities in physical activity guideline compliance(absolute and relative inequalities).We investigated moderation by school level,stratified analyses by income group,and repeated primary analyses using device-measured data.Results:Pooling data from 135 countries/regions(n=1,089,852),we found no association between population-level uniform practices and gender inequalities in physical activity across all ages(absolute:b=-0.2;95%confidence interval(95%CI):-1.7 to 1.3,p=0.74;relative:b=0.1;95%CI:-0.1 to 0.2,p=0.51).Subgroup analysis suggested a positive association in primary school settings(absolute:b=4.3;95%CI:-0.0 to 8.6,p=0.05).Among high-income countries,absolute inequalities were significantly greater in countries/regions with uniform practices(N=37)compared to those without(N=48)(9.1(SD=3.6)vs.7.8 percentage points(SD=4.3)).Repeating analyses using device-measured data(n=32,130;N=24)did not alter our primary finding.From initial descriptive statistics,we found that in countries/regions where a majority of schools(>50%)reportedly use uniforms,there was lower compliance with physical activity guidelines among all gender

关键词： School policy Clothing Child Adolescent Accelerometer

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Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors:The iBoneFIT project

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Journal of Sport and Health Science 2024年第3期13卷 419-427页

作者： Andres Marmol-Perez Jose J.Gil-Cosano esther Ubago-Guisado Francisco J.llorente-Cantarero Juan Francisco Pascual-Gázquez Kirsten K.Ness Vicente Martinez-Vizcaino Jonatan R.Ruiz luis Gracia-Marco Department of Physical Education and Sports Faculty of Sport SciencesSport and Health University Research Institute(iMUDS)University of GranadaGranada 18011Spain Department of Epidemiology and Cancer Control St.Jude Children's Research HospitalMemphisTN 38105USA Department of Communication and Education Loyola University AndalusiaSeville 41704Spain Biosanitary Research Institute ibs.GranadaGranada 18012Spain Maimonides Biomedical Research Institute of Cordoba(IMIBIC) Cordoba 14004Spain CIBEROBN Biomedical Research Networking Center for Physiopathology of Obesity and NutritionCarlos III Health InstituteMadrid 28029Spain Department of Specific Didactics Faculty of EducationUniversity of CordobaCordoba 14071Spain Pediatric and adolescent hematology and oncology service Pediatrics and Pediatric Surgery Clinical Management UnitVirgen de las Nieves University HospitalGranada 18014Spain Health and Social Research Center Universidad de Castilla-La ManchaCuenca 13001Spain

Background Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density(aBMD).However,the prevalence of muscle strength deficits is not well documented,and the associations of muscle strength with aBMD are unknown in this population.Therefore,this study aimed to investigate the prevalence of upper-and lower-body muscle strength deficits and to examine the associations of upper-and lower-body muscle strength with age-,sex,and race-specific aBMD Z-scores at the total body,total hip,femoral neck,and lumbar spine.Methods This cross-sectional study included 116 pediatric cancer survivors(12.1±3.3 years old,mean±SD;42.2%female).Upper-and lower-body muscle strength were assessed by handgrip and standing long jump test,respectively.Dual‑energy X‑ray absorptiometry was used to measure aBMD(g/cm2).Associations between muscle strength and aBMD were evaluated in multivariable linear regression models.logistic regression was used to evaluate the contribution of muscle strength(1-decile lower)to the odds of having low aBMD(Z-score≤1.0).All analyses were adjusted for time from treatment completion,radiotherapy exposure,and body mass index.Results More than one-half of survivors were within the 2 lowest deciles for upper-(56.9%)and lower-body muscle strength(60.0%)in comparison to age-and sex-specific reference values.Muscle strength deficits were associated with lower aBMD Z-scores at all sites(B=0.133–0.258,p=0.001–0.032).Each 1-decile lower in upper-body muscle strength was associated with 30%–95%higher odds of having low aBMD Z-scores at all sites.Each 1-decile lower in lower-body muscle strength was associated with 35%–70%higher odds of having low aBMD Z-scores at total body,total hip,and femoral neck.Conclusion Muscle strength deficits are prevalent in young pediatric cancer survivors,and such deficits are associated with lower aBMD Z-scores at all sites.These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added ben

关键词： Bone health Childhood cancer DXA lean mass Resistance training

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Resilience to structural and molecular changes in excitatory synapses in the hippocampus contributes to cognitive function recovery in Tg2576 mice

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Neural Regeneration Research 2024年第9期19卷 2068-2074页

作者： Carolina Aguado Sara Badesso JoséMartínez-Hernández Alejandro Martín-Belmonte Rocío Alfaro-Ruiz Miriam Fernández Ana esther Moreno-Martínez Mar Cuadrado-Tejedor Ana García-Osta Rafael luján Synaptic Structure laboratory Instituto de Investigación en Discapacidades Neurológicas(IDINE)Department of Medical SciencesFacultad de MedicinaUniversidad de Castilla-La ManchaCampus BiosanitarioAlbaceteSpain Gene Therapy for Neurological Disease Program Center for Applied Medical Research(CIMA)University of NavarraInstituto de Investigación Sanitaria de Navarra(IdiSNA)PamplonaSpain Pharmacology Unit Department of Pathology and Experimental TherapeuticsFaculty of Medicine and Health SciencesInstitute of NeurosciencesUniversity of BarcelonaBarcelonaSpain Neuropharmacology and Pain Group Neuroscience ProgramInstitut d’InvestigacióBiomèdica de BellvitgeIDIBELLL’Hospitalet de LlobregatSpain Department of Pathology Anatomy and PhysiologySchool of MedicineUniversity of NavarraPamplonaSpain UniversitéGrenoble Alpes Grenoble Institut des NeurosciencesGrenobleFrance

Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function.Unraveling the factors that lead to this cognitive resilience to AD offers promising prospects for identifying new therapeutic targets.Our hypothesis focuses on the contribution of resilience to changes in excitatory synapses at the structural and molecular levels,which may underlie healthy cognitive performance in aged AD animals.Utilizing the Morris Water Maze test,we selected resilient(asymptomatic)and cognitively impaired aged Tg2576 mice.While the enzyme-linked immunosorbent assay showed similar levels of Aβ42 in both experimental groups,western blot analysis revealed differences in tau pathology in the pre-synaptic supernatant fraction.To further investigate the density of synapses in the hippocampus of 16-18 month-old Tg2576 mice,we employed stereological and electron microscopic methods.Our findings indicated a decrease in the density of excitatory synapses in the stratum radiatum of the hippocampal CA1 in cognitively impaired Tg2576 mice compared with age-matched resilient Tg2576 and non-transgenic controls.Intriguingly,through quantitative immunoelectron microscopy in the hippocampus of impaired and resilient Tg2576 transgenic AD mice,we uncovered differences in the subcellular localization of glutamate receptors.Specifically,the density of GluA1,GluA2/3,and mGlu5 in spines and dendritic shafts of CA1 pyramidal cells in impaired Tg2576 mice was significantly reduced compared with age-matched resilient Tg2576 and non-transgenic controls.Notably,the density of GluA2/3 in resilient Tg2576 mice was significantly increased in spines but not in dendritic shafts compared with impaired Tg2576 and non-transgenic mice.These subcellular findings strongly support the hypothesis that dendritic spine plasticity and synaptic machinery in the hippocampus play crucial roles in the mechanisms of cognitive resil

关键词： aging Alzheimer´s disease cognitive hippocampus immunoelectron microscopy resilience synapse

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Pembrolizumab autoimmune related diabetes:Moving forward,keep learning

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World Journal of Clinical Oncology 2024年第5期15卷 576-579页

作者： Jose Angel Garcia Diego Alcaraz esther Holgado Felipe Couñago Department of Medical Oncology GenesisCare Spain-San Francisco de Asis University HospitalMadrid 28002Spain Department of Chief of Medical Oncology GenesisCare Spain-San Francisco de Asis University HospitalMadrid 28002Spain Department of Chief of Radiation Oncology GenesisCare-Vithas La Milagrosa HospitalMadrid 28010Spain

Immune checkpoint inhibitors(and more specifically programmed cell death 1/programmed cell death ligand 1 inhibitors as Pembrolizumab)initiated a revolution in the field of melanoma and have now expanded to several tumor subtypes and in increasingly broader clinical contexts,including the adjuvant and neoadjuvant setting,with potentially curable patients and prolonged survival.The side effects related to these drugs include a wide spectrum of manifestations,with endocrinological adverse events being some of the most frequent.Pembrolizumab-induced type 1 diabetes mellitus is an infrequent but potentially serious and not clearly reversible side effect that possesses characteristic clinical features and has high morbidity and mortality,with a chronic impact on quality of life.The etiopathogenesis of this phenomenom needs to be further investigated and a collaborative effort through the involvement of oncologists and other medical specialists is necessary for the correct identification and management of patients at risk.

关键词： Immune checkpoints Pembrolizumab Immunotherapy Side effects Endocrine system Diabetes mellitus

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The Effects of Acupressure on Vomiting, Stress, and Anxiety in Chinese Pregnant Women with Hyperemesis Gravidarum

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Journal of Clinical and Nursing Research 2024年第5期8卷 369-383页

作者： Wenyuan Jiang esther O.Dela Cruz Institute of Health Sciences and Nursing Far Eastern UniversityNicanor Reyes StreetSampalocManila 1015Philippines

Objective:To investigate the role of acupressure therapy in helping pregnant women with HG reduce the frequency or severity of vomiting and relieve stress and anxiety.Method:A quantitative study with a quasi-experimental design and non-equivalent group design was used.Sixty-six valid data points were obtained from pregnant mothers diagnosed with HG in a general hospital in linyi City.These pregnant women received either acupressure(n=33)or general therapeutic care(n=33).They completed standardized questionnaires designed to assess vomiting,anxiety,and stress levels.Results:Data showed no differences between the experimental and control groups before the intervention.After the intervention,there were significant differences in anxiety(P≤0.05)and stress(P≤0.05)scores between the two groups.However,there was no significant difference in vomiting scores(P>0.05)between the two groups after the intervention.The anxiety and stress scores of the experimental group were significantly lower than those of the control group post-intervention,while the vomiting scores of the two groups were similar.Conclusion:The findings suggest that acupressure significantly reduces anxiety and stress in pregnant women with hyperemesis gravidarum(HG)and also helps reduce vomiting.Acupressure presents a viable clinical option for pregnant women seeking relief from HG symptoms.

关键词： Acupressure Anxiety Stress Nausea Vomiting

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