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Biomedical subjects

M Elseviers

Publications and source records attributed to M Elseviers.

At least 19 recordsLinked to original sources
PubMed2006

The obstetrical and neonatal outcome of babies born after single-embryo transfer in IVF/ICSI compares favourably to spontaneously conceived babies.

BACKGROUND: Recently, concern has risen about poor obstetrical and neonatal outcome of singletons after IVF/ICSI. Because the population of patients receiving single-embryo transfer (SET) resulting in singleton pregnancies is different from the one that would have become pregnant (with a singleton) before SET was introduced, we wanted to investigate whether the outcome of singleton pregnancies after SET differed from spontaneously conceived singletons. METHODS: The obstetrical and early neonatal outcome of all pregnancies originating from SET after IVF/ICSI procedures between 1 January 1998 and 31 December 2003, was prospectively collected and analyzed. RESULTS: Data from 251 singleton pregnancies and births after SET were analyzed and compared to data from 59,535 spontaneously conceived singletons retrieved from the Centre for Perinatal Epidemiology. The mean birthweight of the singletons after SET was 3322 g (+/-538 SD) versus 3330 g (+/-531 SD) for the spontaneously conceived singletons (P = 0.82). The mean gestational age was 38.7 weeks (+/-1.9 SD) for SET and 38.9 weeks (+/-1.8 SD) for spontaneously conceived singletons (P = 0.06). The proportion of very preterm birth (<32 weeks) was 0.8% in each group, and the proportion of preterm birth (<37 weeks) was 10.0% for SET singletons and 6.24% for spontaneous singletons (P = 0.03). However, mean birthweight of very preterm, preterm and term SET singleton babies was similar to the mean birthweight in every category of gestational age in the spontaneous conceived control group. Stillbirth was 0.4% for both populations (P = 0.99). CONCLUSIONS: Good prognosis patients, in whom SET is applied, do not only have a higher chance of conception but do not have an unfavourable outcome of their singleton baby when compared to spontaneous singletons.

Adult↗
PubMed2004

Single top quality embryo transfer as a model for prediction of early pregnancy outcome.

BACKGROUND: Single embryo transfer (particularly of a top quality embryo) is an excellent model to correlate embryo quality in terms of morphological criteria to early pregnancy. We investigated whether this model could provide us with more information on what happens after implantation in the first trimester of pregnancy. METHODS: The outcome of 370 consecutive single top quality embryo transfers in patients younger than 38 years was analysed for pregnancy and first-trimester pregnancy loss (FTPL) before 13 weeks of gestation. Analysis was done on each cohort of embryos from which the transferred top quality embryo was selected. Serum HCG levels were measured on day 8 and day 12 after day 3 embryo transfer. The HCG index was calculated as the level of HCG on day 12/HCG on day 8. RESULTS: The pregnancy rate after single top quality embryo transfer was 51.9%. This was independent of the patients' age. FTPL, however, appeared to be age dependent: 15.4% for the whole group, 9% in patients younger than 30 years and 19% in patients above 30 years. The pregnancy rate was 50% in IVF cycles and 52% in ICSI cycles; FTPL was 19% in IVF cycles and 10% in ICSI cycles. Multiple regression analysis showed that these differences originated from age differences between both populations rather than from technique-related factors. An HCG level >or=45 IU/l on day 12 was predictive for ongoing pregnancy with 75.6% sensitivity and 100% specificity; an HCG index >or=3.5 similarly predicted ongoing pregnancy with 72.3% sensitivity and 100% specificity. CONCLUSIONS: These data show that embryo selection for transfer on day 3 can be used as an excellent tool for prediction of pregnancy but not for prediction of FTPL. The pregnancy rate of a single top quality embryo is not related to age, whereas FTPL is age dependent.

Abortion, Spontaneous↗
PubMed2004

A real-life prospective health economic study of elective single embryo transfer versus two-embryo transfer in first IVF/ICSI cycles.

BACKGROUND: We analysed the difference in maternal, neonatal and total costs after single (SET) versus double day 3 embryo transfer (DET). METHODS: We performed a two-centre prospective study of women in their first IVF/ICSI cycle choosing between SET or DET. Infertility treatment data were gathered from a database; maternal and neonatal outcome data from a case report form (CRF); health economic data from medical acts registered in the CRF for the outpatient part and from hospital bills. SET was performed in 206/367 (56.1%) and DET in 161/367 (43.9%) women. RESULTS: In all, 367 transfers yielded 186 positive pregnancy tests, 148 ongoing pregnancies and 136 live deliveries (50.7, 40.3 and 37.1% per embryo transfer) of which 15 (11.0%) were twins. Live birth rate was 37.4% for SET, 36.6% for DET. Intention-to-treat analysis showed differences for: duration of pregnancy (SET: 39.0 +/- 1.4 versus DET: 38.3 +/- 2.2 weeks; P = 0.055), percentage prematurity (8.5 versus 23.8%; P = 0.033), percentage of neonates hospitalized (5.7 versus 17.9%; P = 0.121) and duration of neonatal hospitalization (6.3 +/- 2.2 versus 10.3 +/- 10.1 days; P = 0.01). Total cost after DET was higher (SET: 4700 +/- 3239 versus DET: 8613 +/- 10 105; P = 0.105), due to significantly higher neonatal costs (451 +/- 957 versus 3453 +/- 8154; P < 0.001) and not to differences in maternal costs (4250 +/- 2882 versus 5160 +/- 4106; P = 0.152). CONCLUSIONS: This prospective health economic study shows that transfer of a single top quality embryo is equally effective as, but substantially cheaper than, double embryo transfer in women <38 years of age in their first IVF/ICSI cycle.

Birth Rate↗
PubMed2000

Prognostic value of a new scoring system for hospital mortality in acute renal failure.

AIM AND METHODS: In order to define a prognostic scoring system for hospital mortality of individual patients with acute renal failure (ARF), data were collected prospectively in a single centre study (Stuivenberg General Hospital, Antwerp, Belgium) on 197 adult patients consecutively admitted to the intensive care unit (ICU) during one year. Mean age was 69.8 (+/- 14.7), male/female ratio was 118/79. RESULTS: Hospital mortality was 53%, 26% of the patients who were treated with renal replacement therapy. For developing the model all parameters showing a significant difference between survivors and non-survivors were entered in the multivariate analysis. Two SHARF scores (= Stuivenberg Hospital Acute Renal Failure scores) were developed, one at the time of diagnosis of ARF (T0) and the other 48 hours later (T48): SHARF T0 (7 x age) + (6 x alb0) + (3 x PTT0) + (39 x vent0) + (9 x heartf0) + 52 SHARF T48 (7 x age) + (6 x alb0) + (3 x PTT0) + (43 x vent48) + (16 x heartf48) + 52 age, albumin (alb0) and prothrombine time (PTT0) at T0 are expressed as categories, respiratory support (vent) and heart failure (heartf) at T0 and T48 are presented as absent (0) or present (1). In the linear regression model, r2 was, respectively, 0.36 and 0.43. The area under the receiver operator characteristic (ROC) curves, judging the discrimination ability between survivors and non-survivors, for T0 and T48 were, respectively, 0.87 and 0.90. The Hosmer-Lemeshow goodness-of-fit C statistic for T0 was C = 8.47; df8; p = 0.3 89 and for T48 C = 11.05; df = 8; p = 0.199. CONCLUSION: We conclude that this scoring system, developed for all types of ARF, compares favorably with published scores and can become useful as a bedside tool for predicting hospital mortality in individual patients. A second measuring point increased the predictive value of the model. The results have to be confirmed in an ongoing prospective multicentre study.

Acute Kidney Injury↗
PubMed1998

Comparison between plain and gentamicin containing collagen sponges in infected peritoneal cavity in rats.

OBJECTIVE: To study the usefulness of gentamicin-containing sponges in the infected peritoneal cavity in rats. DESIGN: Controlled study. MATERIAL: 83 Male Wistar rats, 36 of which were treated by plain sponge, 36 by gentamicin-impregnated sponge, and 11 acted as controls. INTERVENTIONS: A standard model of intraperitoneal infection was developed by making a 1 cm long incision in the caecum. MAIN OUTCOME MEASURES: Postoperative mortality, macroscopic and microscopic features of infection, and bacterial concentrations in the abdomen on days 3, 6, and 9. RESULTS: In the respective groups 2, 3 and 2 animals died during operation and 4/34 (11%), 3/33 (9%); and 0/9 died before day 3. There were appreciable reductions in the number of animals with features of infection after 3 days but these were not significant at 6 or 9 days. CONCLUSION: Gentamicin-containing collagen sponges placed on a septic focus in the abdomen reduce local infection for at least 3 days.

Animals↗
PubMed1997

Importance of volume factors in dialysis related hypertension.

OBJECTIVE: To evaluate the relation between total body water and dialysis related hypertension. PATIENTS AND METHODS: Thirty stable chronic hemodialysis patients were studied. Twenty-four-hour ambulatory blood pressure on the day before dialysis, blood pressure before and after dialysis, weight gain, ultrafiltration and total body water were determined. Total body water was measured by body impedance analysis and expressed as percentage of dry weight (TBW %). Ambulatory blood pressure recordings were defined as hypertensive when the blood pressure load (% of readings above 140/90 mmHg) was more than 40%. RESULTS AND CONCLUSION: Patients, classified as normotensive (n = 11) or hypertensive (n = 19), based on 24-hour blood pressure measurements, had significantly different TBW % (54.7 +/- 5.3 vs. 58.9 +/- 4.6%, p = 0.046). Ambulatory blood pressure and postdialysis blood pressure, but not predialysis blood pressure, were significantly correlated with TBW %. Acute volume changes, as reflected by interdialytic weight gain and ultrafiltration did not correlate with TBW %. These changes correlated weakly with predialysis blood pressure. Multivariate analysis showed that only TBW % and antihypertensive medication had an independent influence on 24-hour blood pressure measurements. We conclude that 24-hour blood pressure and blood pressure after dialysis are better related to total body water than blood pressure before dialysis, which was however weakly related to the acute volume overload, induced by interdialytic weight gain. We hypothesize that this could be the result of a more important chronic volume overload leading to an increase in systemic vascular resistance. On the contrary the acute but less important changes in extracellular volume between dialyses cause no hypertension after dialysis and no sustained hypertension over 24 hours, but only in some cases a temporary increase in the blood pressure just before dialysis. This volume overload can be easily determined by measurement of total body water by bioelectrical impedance analysis.

Aged↗
PubMed1988

Evidence for the bioactive conformation in a cyclic hexapeptide analogue of somatostatin containing a cis-peptide bond mimic.

N-methyl- alpha -benzyl-o-aminomethylphenylacetic acid was incorporated into a cyclic somatostatin analogue in order to mimic a cis-peptide bond configuration. The high biological potency of one of the isomers of the cyclic peptide strongly argues in favour of the proposed cis-configuration of the peptide bond at that position in the parent peptide. This represents the first cis-peptide bond mimic which has high biological activity.

Animals↗
PubMed1988

Determination of the chiral purity of dipeptide isosteres containing a reduced peptide bond by gas chromatographic analysis.

The stereochemical purity of psi (CH2-NH) dipeptides has been determined using gas chromatography-mass spectrometry. Different structures were found due to the derivatization procedures. A selective preparation of the linear bistrifluoroacetylated derivative and the monotrifluoroacetylated lactam makes it possible to monitor the chiral purity of the pseudodipeptides synthesized. Racemization occurring during peptide hydrolysis can be differentiated from racemization during the synthesis by using deuterium labelling. The method allows the optimization of the synthesis protocols and will be useful for further monitoring of the chiral purity of the pseudopeptides synthesized.

Chromatography, Gas↗
PubMed1986

Synthesis and conformational study of two L-prolyl-L-leucyl-glycinamide analogues with a reduced peptide bond.

The peptide bond between Pro-Leu or Leu-Gly in Pro-Leu-Gly-NH2 was replaced by a CH2-NH function. The 1H and 13C n.m.r. studies demonstrated that HCl X Pro-Leu psi (CH2-NH)Gly-NH2 10 adopted a conformation in DMSO that is similar to the previously postulated beta-turn for the natural hormone. This was not the case for the other analogue. In vivo tests on 10 revealed an activity approximately equal to the natural compound and an increased toxicity.

Animals↗
PubMedDate not supplied

Absence of tubular proteinuria following environmental exposure to chromium.

Certain chromium compounds are known to be nephrotoxic, but renal damage from long-term environmental or occupational exposure to chromium has not been documented. To detect possible preclinical renal damage, we tested the urine of 55 lifelong residents of an area contaminated with chromium landfill. The levels of four proteins were determined in urine samples: (1) human intestinal alkaline phosphatase, (2) tissue nonspecific alkaline phosphatase, (3) N-acetyl-beta-D-glucosaminidase, and (4) microalbumin. No elevated levels of proteins were found, and there were no significant correlations between urine protein and urine chromium concentrations. We concluded that long-term environmental exposure to chromium dust did not lead to tubular proteinuria.

Adult↗
PubMedDate not supplied

Post insertion catheter care in peritoneal dialysis centers across Europe: results of the Post Insertion Project of the Research Board.

The EDTNA/ERCA survey of Post Insertion Catheter Care in Peritoneal Dialysis (PICC) was a project organised through the Collaborative Research Programme (CRP) of the EDTNA/ERCA. In this survey, data were collected from 54 participating centres in 20 countries. From this survey it became clear that there is no standardised approach to immediate post-catheter insertion treatment protocols. If we want to reduce technique failure of PD related to catheter failure, a first step will be to investigate the different policies used in Europe in order to evaluate the outcome results derived from different policies in post insertion catheter care.

Bandages↗
PubMedDate not supplied

European practice database: results from Greece.

The survey (EPD) took place during December 2002-January 2003 and presents renal care in Greece. A questionnaire, structured at European level and translated into Greek, was sent to all dialysis centres (114) by post. The questionnaire was returned from 74 centres (64.9%). Some important results were: low use of peritoneal dialysis (13.3%), half of PD patients over 65 years old, one ninth of patients on transplantation waiting list, isolation for HBV positive patients (less for HCV and HIV), high use of AV fistulae (71.2%), maintenance and repair of dialysis machines by company technicians, absence of renal dieticians and social workers (but availability from hospital employees) one nurse every 5.54 patients (3.72 if nurse assistants are included), disinfection between shifts carried out chemically (hot or cold) and puncturing of vascular access performed mainly by nurses and nurse assistants. Data can be used to pressurise government for more scientists in the multidisciplinary team to be hired in hospitals, develop further research topics and to develop continuous education programmes.

Age Factors↗
PubMedDate not supplied

The European practice database (EPD): results of the study in thte North-East of Italy.

The survey, realized in 2002-03 in the North-East of Italy, describes renal care in dialysis services. A questionnaire, structured at European level, was sent to all dialysis centres by mail. The questionnaire was returned from 21 centres (61.8%) and related satellite units. Results show nonhomogeneity in renal care. Some important results were: low use of peritoneal dialysis (18%), compared to the rest of Europe, elevated presence of older people on haemodialysis, reduced percentage of patients on transplantation waiting list, diffused use of isolation for HCV positive patients, high use of AV fistulae (84%), low employment of renal technicians, absence of renal dieticians and social workers and nurses performing prevalently direct care. Data can be used for different goals: benchmarking activities, selection of deeper research topics and development of more oriented continuous education activities.

Adolescent↗
PubMedDate not supplied

The Research Board of EDTNA/ERCA: research activities and deliverables.

The Research Board (RB) of EDTNA/ERCA was formed ten years ago to provide opportunities for our members to participate in collaborative research projects at a European level. It provides educational support in research methodology via workshops at conference and in articles published in the Journal. The group has completed a total of seven collaborative research projects in diverse areas of renal care and has recently developed an ambitious new project, the European Practice Database (EPD). The EPD project aims to capture the current practice of renal care professionals in European centres on a three-year repeating cycle. The results of projects are presented at conference and at international scientific meetings by invitation and abstract submission. Recommendations, guidelines or educational material are produced collaboratively with the renal multi-disciplinary community.

Cooperative Behavior↗
PubMedDate not supplied

Comparison of renal care practice in Europe: centre and patient characteristics.

The European Practice Database (EPD) contains data from 8 countries including 276 centres and 21,861 dialysis patients. Comparing patients and centre characteristics, remarkable similarities and pronounced differences in renal practice between different European countries and between centres within each country were found.

Adolescent↗
PubMedDate not supplied

Development of indicators to measure European variation of nursing activities.

This paper describes a study to capture the key roles and activities of nephrology nurses across different countries in Europe. The concept of the study and the need to clarify the activities of the nephrology nurse arose as part of a larger study to develop the European Practice Database (EPD) (1). The Research Board (EDTNA/ERCA) needed to identify key questions that would detect significant differences in the role and responsibilities of nephrology nurses in different countries and monitor the evolution over time of nephrology nursing practice in Europe. It was therefore appropriate to devise a separate small study to generate evidence based questions for the EPD and confirm the reliability and usefulness of the information captured.

Adult↗