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Hospital de Órbigo, Spain

Ribas-Maynou J.,Autonomous University of Barcelona | Garcia-Peiro A.,Autonomous University of Barcelona | Fernandez-Encinas A.,Autonomous University of Barcelona | Amengual M.J.,Institute Universitari Parc Tauli | And 4 more authors.
PLoS ONE | Year: 2012

It is known that sperm samples from recurrent pregnancy loss (RPL) couples have an increase in their sperm DNA fragmentation (SDF), but no studies have been performed in order to identify differences between single stranded SDF (ssSDF) and double stranded SDF (dsSDF) in these patients. This could be relevant because the type of DNA damage could have different effects. Semen samples were classified attending their clinical status: 25 fertile donors and 20 RPL patients with at least two unexplained first trimester miscarriages. SDF was analysed using alkaline and neutral Comet assay, SCD test and pulsed-field gel electrophoresis (PFGE), and ROC analysis including data from 105 more infertile patients (n = 150) was performed to establish predictive threshold values. SDF for alkaline and neutral Comet, and the SCD test was analysed in these categories of individuals. Data revealed the presence of two subgroups within fertile donors. The values obtained were 21.10±9.13, 23.35±10.45 and 12.31±4.31, respectively, for fertile donors with low values for both ssSDF and dsSDF; 27.86±12.64, 80.69±12.67 and 12.43±5.22, for fertile donors with low ssSDF and high dsSDF; and 33.61±15.50, 84.64±11.28 and 19.28±6.05, for unexplained RPL patients, also showing a low ssSDF and high dsSDF profile. This latter profile was seen in 85% of unexplained RPL and 33% of fertile donors, suggesting that it may be associated to a male risk factor for undergoing RPL. ROC analysis regarding recurrent miscarriage set the cut-off value at 77.50% of dsDNA SDF. PFGE for low ssSDF and high dsSDF profile samples and positive controls treated with DNase, to induce dsDNA breaks, showed a more intense band of about 48 kb, which fits the toroid model of DNA compaction in sperm, pointing out that some nuclease activity may be affecting their sperm DNA in RPL patients. This work identifies a very specific SDF profile related to the paternal risk of having RPL. © 2012 Ribas-Maynou et al.

Sonography has been the fundamental pillar of fetal diagnosis, and until relatively recently, no other valid and reliable noninvasive technique that could adequately determine fetal morphology was available. However, even after the technological advances in obstetric sonography, is still unable to detect some anomalies. One example of this shortcoming is the morphological study of the face and neck. Owing to the ossification of adjacent structures and interposition of the tongue, sonography is not accurate in the detection of some of the most common anomalies. Enormous advances have been made in fetal magnet resonance imaging since it was first described 25 years ago. The usefulness of this modality as a tool to complement sonography in fetal evaluation is now firmly established. MRI provides useful information about orofacial anatomy, enabling accurate evaluation of both the primary and secondary palates. © 2011 SERAM. Published by Elsevier España, S.L. All rights reserved.

Ribas-Maynou J.,Autonomous University of Barcelona | Garcia-Peiro A.,Autonomous University of Barcelona | Fernandez-Encinas A.,Autonomous University of Barcelona | Abad C.,Institute Universitari Parc Tauli | And 4 more authors.
Andrology | Year: 2013

Summary: Sperm DNA fragmentation (SDF) is becoming an important test to assess male infertility. Several different tests are available, but no consensus has yet been reached as to which tests are most predictive of infertility. Few publications have reported a comprehensive analysis comparing these methods within the same population. The objective of this study was to analyze the differences between the five most common methodologies, to study their correlations and to establish their cut-off values, sensitivity and specificity in predicting male infertility. We found differences in SDF between fertile donors and infertile patients in TUNEL, SCSA, SCD and alkaline Comet assays, but none with the neutral Comet assay. The alkaline COMET assay was the best in predicting male infertility followed by TUNEL, SCD and SCSA, whereas the neutral COMET assay had no predictive power. For our patient population, threshold values for infertility were 20.05% for TUNEL assay, 18.90% for SCSA, 22.75% for the SCD test, 45.37% for alkaline Comet and 34.37% for neutral Comet. This work establishes in a comprehensive study that the all techniques except neutral Comet are useful to distinguish fertile and infertile men. © 2013 American Society of Andrology and European Academy of Andrology.

Ribas-Maynou J.,Autonomous University of Barcelona | Fernandez-Encinas A.,Autonomous University of Barcelona | Garcia-Peiro A.,Autonomous University of Barcelona | Prada E.,Hospital Universitari Mutua Of Terrassa | And 4 more authors.
Andrology | Year: 2014

Sperm cryopreservation is widely used for both research and reproduction purposes, but its effect on sperm DNA damage remains controversial. Sperm DNA fragmentation (SDF) has become an important biomarker to assess male infertility. In particular, the differentiation between single- and double-stranded DNA fragmentation (ssSDF and dsSDF) has clinical implications for male infertility where ssSDF is associated with reduced fertility, whereas dsSDF is associated with increased risk of miscarriage. In this study, semen samples from 30 human males have been analysed in both fresh and cryopreserved using the alkaline and neutral Comet assays. Results show an increase of about 10% of ssSDF, assessed by the alkaline Comet assay, regardless of the male fertility status. Neutral Comet analysis of dsSDF does not show any statistical increase when comparing fresh and cryopreserved samples in any of the patient groups. Results support previous reports that oxidative stress is the major effector in DNA damage during sample cryopreservation, as, on one hand, ssSDF has previously been related to oxidative damage and, on the other hand, we have not found any effect on dsSDF. Therefore, there might be a slight risk of decreased fertility after using a freezed sample, but no evidence for increased miscarriage risk from cryopreserved spermatozoa should be expected. © 2013 American Society of Andrology and European Academy of Andrology.

Epelde F.,Institute Universitari Parc Tauli | Iglesias-Lepine M.L.,Institute Universitari Parc Tauli | Anarte L.,Institute Universitari Parc Tauli
Anales del Sistema Sanitario de Navarra | Year: 2012

Background. Length of stay is the main determinant of the cost of hospitalization, which is why strategies must be implemented to reduce conventional hospital stays while maintaining quality levels. Short Stay Units (SSU) were created with the aim of reducing hospital stays in a certain group of patients and pathologies.The aim of this paper is to evaluate the literature on the evidence of decreased length of stay, efficiency, readmissions in the emergency department, cost-effectiveness, and mortality of these units. Methods. We made a systematic review of the literature, using the MeSH terms "Observation Unit", "Short- Stay Ward", "Monday to Friday Clinic", "Monday to Friday Surgery Ward", "Short Stay Hospitalization", "Alternative to Conventional Hospitalization", "Alternative Admissions" in the MEDLINE database, Web of Knowledge and the Cochrane Library from January 1 1960 to January 1 2012. The studies reviewed were selected according to the U.S. Preventive Services Task Force Protocol. Results. The SSU made it possible in certain groups of patients to reduce the period of stay and maintain efficiency, showing no increases in emergency readmissions or mortality. Conclusions. The SSU can be an instrument to reduce the cost of the health process in a certain group of pathologies.

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