Vitrification of lower grade cleavage stage embryos and pregnancy outcome (2013)

Posted on August 22, 2017 by Jason Curtis

Type of publication:
Conference abstract

Author(s):
*Binnersley S.; *Hughes G.; *Hatton A.; *Gittins V.; *Kasraie J.

Citation:
Human Fertility; 2013; vol. 16 (no. 3)

Abstract:
Introduction : Conservation of viable embryos minimises risk to patients from repeated stimulation/egg collection, reduces costs and maximises cumulative success rates, but national practice varies greatly. Many clinics only cryopreserve top quality embryos, potentially leading to the disposal of viable embryos and unnecessary further cycles of IVF. Our clinics experience of survival rates from traditional 'slow'freezing, where fragmentation may provide additional foci for ice crystal formation, meant that, when our clinic introduced Vitrification in 2008, we continued to cryopreserve only embryos with < 5% fragmentation. However survival and pregnancy rates using vitrification were such that from May 2010, following validation of survival rates, criteria were relaxed to allow embryos with 15% fragmentation to be stored. Materials and Methods: Retrospective analysis of 156 frozen (vitrified) embryo transfer cycles. Embryos were classified as top (<=5% fragmentation) or non-top (5 to 15% fragmentation) quality. Two embryos were transferred in all cycles. Three groups were compared: 1 < Two top quality (n=109), 2=One top and one non-top (n=20), 3=two non-top (n=27) quality transferred. Vitrification cooling/warming utilised Origio media and Cryo-Bio system sealed straws. Results: There was no significant difference for patient age (p=0.48), survival rates of blastomeres in each group (97.9% vs 96.7% and 98.1%, p=0.62), biochemical pregnancy rate (36.7% vs 30.0% vs 33.3%, p=0.62), clinical pregnancy rate (20.2% vs 10.0% vs 22.2%, p=0.36), or implantation rate (12.8% vs 5% vs 12.96%, p=0.19) in all groups. Conclusion: This small retrospective study appears to show that vitrication of lower grade embryos (15% fragmentation) results in similar pregnancy rates to the vitrification of only top quality embryos. The resultant increase in the number of stored embryos and frozen embryo transfers decreases risk to the patient and cost to the healthcare economy whilst increasing the cumulative pregnancy rate from single 'fresh'IVF cycles

Medical student's perceptions of forensic pathology (2017)

Posted on August 22, 2017 by Jason Curtis

Type of publication:
Conference abstract

Author(s):
*Iles K.L.

Citation:
Journal of Pathology; Mar 2017; vol. 241, Supplement 1, Page S6

Abstract:
Forensic pathology is an important sub-specialty of pathology which requires a variety skills that are relevant and transferable to many other areas of medicine. Despite this, it does not feature in the undergraduate curriculum of most medical schools meaning that knowledge specific to forensic medicine such as wound terminology may not be taught. A lack of formal teaching and an ever increasing dramatised presence of the specialty in the media may lead to a misrepresentation of the role of forensic pathologists. As a result this study aimed to examine final year medical student's perceptions of the role of the forensic pathologists and their confidence in knowledge of important aspects of forensic medicine. An online survey was developed to assess these areas which was distributed to final year medical students at a UK institution via email. From the respondents, the overall perception of the job role was correct, however there appeared to be some misconceptions regarding the role of a forensic scientist, or crime scene investigator in comparison to a forensic pathologist. The study also highlighted that students did not feel confident in differentiating between wound types using the correct terminology. This is important as injuries are common presentations in many clinical areas, and incorrect terminology may have mediocolegal implications. This study has highlighted the need for clarification of the job role of the forensic pathologist. There is a greater need for forensic pathology in the undergraduate curriculum, which should focus on description and terminology of wounds and injuries.

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Clinical risk factors predicting genital fungal infections with sodium–glucose cotransporter 2 inhibitor treatment: The ABCD nationwide dapagliflozin audit (2017)

Posted on August 11, 2017 by Jason Curtis

Type of publication:
Journal article

Author(s):
Ken Yan Thong, Mahender Yadagiri, Dennis Joseph Barnes, *David Stuart Morris, Tahseen Ahmad Chowdhury, Ling Ling Chuah, Anthony Michael Robinson, Stephen Charles Bain, Karen Ann Adamson, Robert Elford John Ryder, ABCD Nationwide Dapagliflozin Audit contributors

Citation:
Primary Care Diabetes 2017 [published online 29th June 2017]

Abstract:
Introduction

Treatment of type 2 diabetes with sodium–glucose cotransporter 2 (SGLT2) inhibitors may result in genital fungal infections. We investigated possible risk factors for developing such infections among patients treated with the SGLT2 inhibitor dapagliflozin.

Methods

The Association of British Clinical Diabetologists (ABCD) collected data on patients treated with dapagliflozin in routine clinical practice from 59 diabetes centres. We assessed possible associations of patient’s age, diabetes duration, body mass index, glycated haemoglobin, renal function, patient sex, ethnicity and prior genital fungal infection, urinary tract infection, urinary incontinence or nocturia, with the occurrence of ≥1 genital fungal infection within 26 weeks of treatment.

Results

1049 out of 1116 patients (476 women, 573 men) were analysed. Baseline characteristics were, mean ± SD, age 56.7 ± 10.2 years, BMI 35.5 ± 6.9 kg/m2 and HbA1c 9.4 ± 1.5%. Only patient sex (13.2% women vs 3.3% men) and prior history of genital fungal infection (21.6% vs 7.3%) were found to be associated with occurrence of genital fungal infections after dapagliflozin treatment, adjusted OR 4.22 [95%CI 2.48,7.19], P < 0.001 and adjusted OR 2.41 [95% CI 1.04,5.57], P = 0.039, respectively.

Conclusion

Women and patients with previous genital fungal infections had higher risks of developing genital fungal infections with dapagliflozin treatment.