Mcclanahanholgersen6350

etermining prognosis and care for patients with CRS amid the COVID-19 pandemic.

Current reference values for pediatric dyslipidemia used in China were not developed based on local population studies and did not consider age and sex differences.

In this study, we aimed to determine suitable reference values for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and non-high-density lipoprotein cholesterol (nonHDL-C) for Chinese children and adolescents using a national multicenter school-based study.

A total of 15,830 students aged 6-17 years were recruited from seven provinces of China. Age- and sex-specific percentile values for each lipid indicator were derived based on levels measured in the fasting state, and percentile curves of each indicator were plotted using the LMS method.

Serum lipid levels varied considerably with age in both sexes. Among boys, the cut-off value for high TC, nonHDL-C, LDL-C, and TG, based on the value of the 95th percentiles, ranged from 4.58 to 5.39, 3.34 to 3.99, 2.69 to 3.31, and 1.22 to 1.83 mmol/L, respectively; among girls, the cut-off value for high TC, nonHDL-C, LDL-C, and TC ranged from 5.01 to 5.39, 3.66 to 3.97, 2.97 to 3.32, and 1.41 to 1.93 mmol/L, respectively. The cut-point for low HDL-C ranged from 0.84 to 1.08 mmol/L in boys and from 0.89 to 1.04 mmol/L in girls.

These findings may help to determine age- and sex-specific reference values for serum lipids among Chinese children and adolescents and provide valuable guidance for screening of dyslipidemia.

These findings may help to determine age- and sex-specific reference values for serum lipids among Chinese children and adolescents and provide valuable guidance for screening of dyslipidemia.

The treatment of chronic total coronary occlusions (CTO) carries the highest radiation exposure among percutaneous coronary interventions (PCI). In order to minimize radiation damage, we need to understand and optimize the contribution of all components of radiation exposure.

A total of 1000 CTO procedures performed between 2011 and 2020 were compared according to implemented radiation modifications. Group 1 used the original set-up of the X-ray equipment (Artis Zee, Siemens). In group 2 a modified protocol aimed at reducing the fluoroscopy exposure, in group 3 further modifications aimed at reducing cineangiographic exposure.

Despite an increased lesion complexity, Air Kerma (AK) was reduced from 2619 mGy (1653-4574) in group 1 to 2178 mGy (1332-3500; p < 0.001) in group 2 by mainly reducing fluoroscopic contribution by 54.1%, the cineangiographic contribution was lowered by only 6.6%. In group 3 AK dropped drastically to 746 mGy (480-1225; p < 0.001) mainly by reducing the cineangiographic contribution by 53.4%, still there was a further reduction of fluoroscopy contribution of 8.2%. This also led to a reduction of the skin entry dose from 1038 mGy (690-1589) in group 2 to 359 mGy (204-591; p < 0.001) in group 3. This was achieved both in normal weight and obese patients, and both in antegrade and retrograde procedures.

The present study demonstrates that by modifying both the fluoroscopic and cineangiographic contribution to radiation exposure a drastic reduction of radiation risk can be achieved, even in obese patients. Currently accepted radiation thresholds may no longer be a limit for CTO PCI.

The present study demonstrates that by modifying both the fluoroscopic and cineangiographic contribution to radiation exposure a drastic reduction of radiation risk can be achieved, even in obese patients. Currently accepted radiation thresholds may no longer be a limit for CTO PCI.All studies show that the primary reason for women to consider elective egg freezing (EEF) is the lack of a partner. The first question then is where this shortage comes from and how it can be remedied. The main cause of the 'lack of partner' issue for highly educated women (the group most involved in elective egg freezing) is the reversed gender gap in education. It is concluded that EEF may increase individual reproductive autonomy but does not increase reproductive freedom for the group of highly educated women. Regardless of how many women freeze their eggs, a large number of educated women will eventually have to choose between going it alone as a single mother or looking for another life goal. Finally, some possible policy measures are proposed to reduce the gender gap and thus remove the real cause of the problem.

How do anti-Müllerian hormone (AMH) concentrations in women with and without arthritis compare? Is there an association between AMH and arthritis drug regimen?

In this prospective cohort study, AMH was measured at two time points (T

and T

) in 129 premenopausal women with arthritis. AMH at T

was compared with that from a bank of serum samples from 198 premenopausal women without arthritis. Primary outcomes were (i) diminished ovarian reserve (DOR) (AMH <1.1ng/ml) and (ii) annual rate of AMH decrease. Univariate, multivariable and Firth logistic regression identified variables associated with annual AMH decrease in excess of the 75th percentile.

Median time between T

and T

was 1.72 years. At time T

, median age-adjusted AMH in women with arthritis was significantly lower than that of women without arthritis (median 2.21ng/ml versus 2.78ng/ml; P=0.009). Women with arthritis at highest risk for DOR had a history of tubal sterilization or were over the age of 35. Those with highest odds of having an annual AMH decrease in excess of the 75th percentile (over 28% decrease per year) were those over the age of 35 or who sought care for infertility. Women with arthritis taking methotrexate alone (OR 0.08, 95% CI 0.01-0.67) or methotrexate plus tumour necrosis factor-alpha antagonists (OR 0.13, 95% CI 0.02-0.89) were less likely to be in the highest quartile of annual AMH decrease than women with arthritis not taking medication.

Women with arthritis had lower AMH than healthy controls. Long-term methotrexate use was not associated with an annual AMH decrease.

Women with arthritis had lower AMH than healthy controls. Long-term methotrexate use was not associated with an annual AMH decrease.

Do women of racial minorities aged 40 years or older have similar reproductive and obstetric outcomes as white women undergoing IVF?

A retrospective cohort study conducted at a single academic university-affiliated centre. The study population included women aged 40 years or older undergoing their first IVF cycle with fresh cleavage-stage embryo transfer stratified by racial minority status minority (black or Asian) versus white. Clinical intrauterine pregnancy and live birth rate were the primary outcomes. Preterm delivery (<37 weeks) and small for gestational age were the secondary outcomes. Odds ratios with 95% confidence intervals were estimated. P < 0.05 was considered to be statistically significant.

A total of 2050 cycles in women over the age of 40 years were analysed, 561 (27.4%) of which were undertaken by minority women and 1489 (72.6%) by white women. Minority women were 30% less likely to achieve a pregnancy compared with their white (non-Hispanic) counterparts (adjusted OR 0.68, CI 0.54 to 0.87). check details Once pregnant, however, the odds of live birth were similar (adjusted OR 1.23, CI 0.91 to 1.67). Minority women were significantly more likely to have lower gestational ages at time of delivery (38.5 versus 39.2 weeks, P = 0.009) and were more likely to have extreme preterm birth delivery 24-28 weeks (5.5 versus 1.0%, P = 0.021).

Minority women of advanced reproductive age are less likely to achieve a pregnancy compared with white (non-Hispanic) women. Once pregnancy is achieved, however, live birth rates are similar albeit with minority women experiencing higher rates of preterm delivery.

Minority women of advanced reproductive age are less likely to achieve a pregnancy compared with white (non-Hispanic) women. Once pregnancy is achieved, however, live birth rates are similar albeit with minority women experiencing higher rates of preterm delivery.

Is the reproductive outcome similar after gonadotrophin-releasing hormone agonist (GnRHa) trigger followed by luteal human chorionic gonadotrophin (HCG) boluses compared with HCG trigger and a standard luteal phase support (LPS)?

Two open-label pilot randomized controlled trials (RCT) with 250 patients from 2014 to 2019, with a primary outcome of ongoing pregnancy per embryo transfer. Patients with ≤13 follicles on the trigger day were randomized (RCT 1) to Group A (n = 65) GnRHa trigger followed by a bolus of 1500IU HCG s.c. on the oocyte retrieval day (ORD) and 1000IU HCG s.c. 4 days later, and no vaginal LPS; or Group B (n = 65) 6500IU HCG trigger, followed by a standard vaginal progesterone LPS. Patients with 14-25 follicles on the trigger day were randomized (RCT 2) to Group C (n = 60) GnRHa trigger followed by 1000IU HCG s.c. on ORD and 500IU HCG s.c. 4 days later, and no vaginal LPS; or Group D (n = 60) 6500IU HCG trigger and a standard vaginal LPS.

In RCT 1, the ongoing pregnancy rate was 44% (22/50) in the GnRHa group versus 46% (25/54) in the HCG trigger group (RR 0.95, 95% CI 0.62-1.45). No ovarian hyperstimulation syndrome (OHSS) was seen in Groups A or B. In RCT 2, the ongoing pregnancy rate was 51% (25/49) in the GnRHa group versus 60% (31/52) in the HCG trigger group (RR 0.86, 95% CI 0.60-1.22). The OHSS rates were 3.3% and 6.7%, respectively.

Although a larger-scale study is needed before standard clinical implementation, the present study supports that the exogenous progesterone-free LPS is efficacious, simple and patient-friendly.

Although a larger-scale study is needed before standard clinical implementation, the present study supports that the exogenous progesterone-free LPS is efficacious, simple and patient-friendly.

Is natural cycle IVF treatment beneficial to middle-aged women with poor ovarian response?

Retrospective investigation of outcomes in women aged 45 years and older, who underwent natural cycle IVF treatment between 2009 and 2018 in a single assisted reproduction clinic with the aim of reporting several successful outcomes.

In total, 2408 IVF retrievals in women aged 45 years and older were included in this study. Mean serum FSH level on day 3 was 21.4 ± 12.5 (range 0.3-93.7) IU/ml. One fresh cleavage-stage embryo was transferred in 37.4% (900/2408) of the initiated cycles. The overall clinical pregnancy rate and live birth rate per fresh embryo transfer were 2.8% (25/900) and 0.8% (7/900), respectively. Natural cycle IVF treatment led to seven successful deliveries during the period. All seven women who successfully delivered were poor ovarian responders who met the diagnostic Bologna criteria and, among them, three had elevated serum FSH levels on day 3 (range 39.0-47.1 mIU/ml). All seven had full-term delivery, and no congenital abnormalities were observed in their infants. No significant difference was found in serum FSH level on day 3 between those with and without positive beta-HCG test results.

These findings suggest that natural cycle IVF treatment could be an option for older poor responders in countries that do not permit egg donation. Careful counselling is required, however, because of the low probability of live births after IVF in middle-aged women.

These findings suggest that natural cycle IVF treatment could be an option for older poor responders in countries that do not permit egg donation. Careful counselling is required, however, because of the low probability of live births after IVF in middle-aged women.