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Guerin P.,VetAgro Sup | Menezo Y.,UNILABs | Menezo Y.,Laboratoire dEylau
Zygote | Year: 2011

The culture of early preimplantation stage embryo is still delicate and the metabolic pathways of embryos are not completely understood. Embryo needs are evolutionary during the preimplantation development, consequently it is difficult to meet embryo needs in vitro. Culture conditions have to respect several physical and chemical equilibria: such as redox potential, pH, osmotic pressure, metabolic flux of energetic compounds, endogenous pools of amino acids and transcripts, etc. Embryo culture media are generally supplemented with amino acids, glucose, other energetic metabolites and antioxidant compounds, vitamin, and growth factors etc. Furthermore autocrine and paracrine regulation of embryo development probably exist. In fact embryo culture conditions have to be as non-toxic as possible. Various types of co-culture systems have been devised to overcome these problems. Complex interrelations exist between embryos and co-cultured cells. The beneficial effects of co-cultured cells may be due to continuous modifications of the culture medium, i.e. the elimination of toxic compounds and/or the supply of embryotrophic factors. Copyright © Cambridge University Press 2010.

Montjean D.,UNILABS | Entezami F.,Laboratoire Dynabio | Lichtblau I.,UNILABS | Belloc S.,UNILABS | And 2 more authors.
Journal of Assisted Reproduction and Genetics | Year: 2012

Purpose: The purpose of this study is to study lipid metabolism in oocytes and embryos that is a neglected parameter in human IVF. Methods: We have tested the total carnitine content (TC) in the follicular fluid of 278 patients (217 non pregnant, 61 pregnant) undergoing IVF. Results: The follicular fluid TC is neither correlated with the circulating estradiol content in serum nor with the outcome the IVF attempt. Carnitine, through the carnitine shuttle, is a major partner in lipid beta oxidation, metabolic pathway involved in the acquisition of oocyte competence. The expression of carnitine synthesis enzymes and lipid beta oxidation was studied in cumulus cells collected at the time of ovum retrieval and in oocyte. Surprisingly the expression for carnitine synthesis is not detectable in oocytes whereas the enzymes involved in lipid beta oxidation are rather strongly expressed. Conclusions: The addition of carnitine in oocyte maturation and embryo culture media should not be overlooked. © 2012 Springer Science+Business Media, LLC.

LONDON & GENEVA--(BUSINESS WIRE)--The joint owners of Switzerland-based Unilabs, private equity funds Apax Europe VI, Nordic Capital Fund VI (“Nordic Capital”) and Apax France VII, announced today that Nordic Capital and Apax Partners France, have accepted an offer from Apax IX, advised by Apax Partners LLP, for the acquisition of their respective stakes in Unilabs. Financial terms of the transaction are not being disclosed. Under the new ownership structure, Unilabs will be able to continue to pursue its successful M&A strategy and be at the forefront of the ongoing consolidation of the European laboratory space. The transaction marks the successful completion of the joint ownership between funds advised by Apax Partners LLP, Nordic Capital and Apax Partners France (jointly with Altamir), which saw Unilabs taken private from the Swiss stock exchange in November 2007 and merged with the diagnostic division of pan-European healthcare provider Capio in 2008. Throughout the ownership, funds advised by Apax Partners LLP, Nordic Capital, and Apax Partners France have made significant investments into the business to pursue a shared vision of creating what is today Europe’s most modern and professionalised medical laboratory business. With over 112 laboratories and 43 medical imaging units across 10 European countries and emerging positions in the Middle East and Latin America, Unilabs has grown to become one of Europe’s leading medical diagnostics businesses. Offering the most comprehensive portfolio of diagnostic services in Europe, Unilabs’ 5,300 employees provide reliable and actionable diagnostic information, which is essential for effective treatment, thereby improving patients’ lives and contributing to the optimisation of rising healthcare costs. Having taken Unilabs to this unique position, Nordic Capital and Apax Partners France have decided to sell their investment in Unilabs to Apax IX, which will support the company as it takes advantage of the strong market outlook and consolidation opportunities. Fredrik Näslund, Partner, NC Advisory AB, advisor to the Nordic Capital Funds, said: “By drawing on a deep expertise and successful track record in the healthcare sector, Nordic Capital has been able support the creation of a truly market leading business. We would like to thank Jos Lamers and the management team for their dedication and commitment to driving the company’s growth strategy and development.” Echoing the support to Unilabs’ management team, Bertrand Pivin, partner at Apax Partners France, commented: “We are pleased to exit in the knowledge that Unilabs, under the continued partnership with Apax Partners LLP, will be ideally equipped to pursue its journey and we wish them the best of success.” Driving a successful M&A strategy in a highly fragmented European laboratory market by acquiring smaller and medium-sized laboratories is critical to the future strategy of the business. Unilabs will therefore continue to be at the forefront of the ongoing consolidation of the European laboratory space. Jos Lamers, CEO of Unilabs, commented: “I would like to thank our partners for sharing our vision and for their support in building a company with solid market leadership positions. Today’s transaction will allow us to pursue our ambition to become a proactive partner to caregivers and patients in all areas of diagnostics – from laboratory diagnostics to pathology and medical imaging. We will achieve this by investing in innovative services, pursuing operational excellence and conducting further M&A activity to expand our European and international presence.” Steven Dyson, Partner at Apax Partners LLP, commented: “Under the leadership of CEO Jos Lamers and his executive team, Unilabs and its 5,300 employees have done an outstanding job in growing organic revenues at close to double market rates, and they continue to generate expanding operating margins. We are excited to continue our successful collaboration and to support the company in its future ambitions.” With over 112 laboratories and 43 imaging units and a broad catalogue of more than 2,500 diagnostic tests, Unilabs is one of Europe’s leading providers of clinical laboratory testing and medical diagnostic imaging services. Headquartered in Geneva, the Unilabs Group services sectors ranging from private and public healthcare providers to local governments, from pharmaceutical companies to the general public. The Unilabs Group employs more than 5,300 people worldwide, successfully operating laboratory and medical diagnostic imaging facilities in 12 countries, and generating annual revenues of €673m in 2015. Its network of facilities provides its customers with one of the broadest geographic footprints of any clinical laboratory and medical diagnostic services provider in Europe. We are at the heart and start of all effective treatment decisions: www.unilabs.com Apax Partners LLP is a leading global private equity advisory firm. Over its more than 30-year history, Apax Partners LLP has raised and advised funds with aggregate commitments in excess of $48 billion*. Funds advised by Apax Partners LLP invest in companies across four global sectors of Healthcare, Tech and Telco, Services and Consumer. These funds provide long-term equity financing to build and strengthen world-class companies. In the healthcare sector they have completed more than 80 investments, including in medical devices, pharmaceuticals and healthcare services. For further information please see www.apax.com *Funds raised since 1981, commitments converted from fund currency to USD at FX rates as at September 30, 2016. Nordic Capital private equity funds have invested in mid-market companies primarily in the Nordic region since 1989. Through committed ownership and by targeting strategic development and operational improvements, Nordic Capital enables value creation in its investments. Nordic Capital Funds invest in companies in northern Europe and in selected investment opportunities internationally. The most recent fund is Nordic Capital Fund VIII with EUR 3.5 billion in committed capital, principally provided by international institutional investors such as pension funds. Nordic Capital Funds are based in Jersey, Channel Islands, and are advised by the NC Advisory companies in Sweden, Denmark, Finland, Norway, Germany and the UK. For further information: www.nordiccapital.com Apax France is a leading private equity firm in French-speaking European countries. With more than 40 years of experience, Apax France provides long-term equity financing to build and strengthen world-class companies. Funds managed and advised by Apax France exceed €3 billion. These funds invest in fast-growing middle-market companies across four sectors of specialisation. Altamir is a listed private equity company (Euronext Paris-B, LTA) with more than €650m in assets under management. The company invests via and with the funds managed or advised by Apax Partners France and Apax Partners LLP, two leading private equity firms in their respective markets. It provides access to a diversified portfolio of fast-growing companies across Apax’s sectors of specialisation (TMT, Retail & Consumer, Healthcare, Business & Financial Services) and in complementary market segments (mid-sized companies in French-speaking European countries and larger companies across Europe, North America and key emerging markets). The transaction is subject to regulatory approvals and the parties expect closing to occur in early 2017. Rothschild & Co acted as M&A advisor to the Sellers on the transaction. Apax Partners LLP was advised by Simpson Thacher & Bartlett LLP and Vinge. Nordic Capital was advised by Mannheimer Swartling. Apax France was advised by Allen & Overy LLP.

Beris P.,University of Geneva | Georgiou G.,Unilabs
Seminars in Hematology | Year: 2012

Myelodysplastic syndromes (MDS) were first presented as a separate entity in hematology in 1982 by the French-American-British (FAB) group. Although widely accepted, this classification was revised in 2001 and again in 2008 by the World Health Organization (WHO). During that time, a great effort was made by diagnostic entities of world renown as well as by other research groups and individuals to establish a reliable prognostic system. Today, two systems are accepted by the hematologic community: the International World Prognostic Scoring System (IPSS) and the WHO Prognostic Scoring System (WPSS). Almost from the beginning, it was assumed that MDS are clonal disorders. Cytogenetics not only proved the clonality in the majority of cases but also greatly contributed to the stratification of patients into risk categories. With the progress made in treatment for MDS, comorbidities became an important part of the integral pretreatment consideration, as patients with a high index of comorbidity evaluation very often do not benefit from treatment. Recent advances in the diagnostic and prognostic evaluation of MDS patients were achieved by studying the effect of age in different MDS subgroups and the role of molecular markers in predicting clinical evolution. © 2012 Elsevier Inc.

PubMed | Unilabs, University of Geneva and University of Basel
Type: Journal Article | Journal: BJOG : an international journal of obstetrics and gynaecology | Year: 2016

Recommendations in Switzerland on screening for gestational diabetes endorse the International Association of Diabetes in Pregnancy Study Group consensus. As universal testing is time consuming and glucose loading is unpleasant, the recommendations include a simplification, not performing the glucose loading in women with fasting glycaemia <4.4 mmol/l. Our objective was to evaluate the diagnostic performance of this simplified strategy, compared with the complete test, in our population with a low prevalence of gestational diabetes.We collected 2298 complete 75-g glucose tolerance tests. We simulated stopping the test, so avoiding the glucose loading and further glycaemia, if fasting glycaemia was <4.4 or 5.1 mmol/l.Unselected pregnant women from Geneva and Basel, at 24-28 weeks of gestation.We calculated the sensitivity, and the percentage of women who would avoid the complete test with the strategy based on fasting glycaemia.The prevalence of gestational diabetes was 10.9% in our population. Among 251 women with gestational diabetes, fasting glycaemia was 5.1 mmol/l in 119 women (47.4%), between 4.4 and <5.1 mmol/l in 78 women (31.1%) and <4.4 mmol/l in 54 women (21.5%). Proceeding with the complete test only in women with fasting glycaemia between 4.4 and <5.1 mmol/l will result in a sensitivity of 78.5%. This strategy would avoid glucose loading in 63.8% of women.Screening with fasting glycaemia is an attractive alternative to universal screening with the complete 75-g glucose tolerance test. This strategy is, however, slightly less sensitive than previously reported in higher-risk populations.Fasting glycaemia can be considered as an alternative to the complete test for gestational diabetes screening.

PubMed | Ginefiv, Centro Medico Palencia, University of León, Unilabs and 2 more.
Type: | Journal: Journal of reproductive immunology | Year: 2015

The aim of this study was to identify the candidates for natural killer (NK) testing and to define the best methodology. For this purpose a prospective study was performed on 73 women with repeated implantation failure (RIF). RIF was considered to exist in patients not achieving clinical pregnancy after three transfers with at least one good-quality embryo. Idiopathic RIF was considered to exist in patients in whom thrombophilia, hysteroscopy and endometrial culture were normal, and no chromosomal factor was suspected. Thirty-two of the 73 patients were considered to have idiopathic RIF, and 17 fertile women with children were taken as controls. Immunohistochemical staining for endometrial CD56+ and blood CD56+ or CD16+ NK cells measured using flow cytometry were compared during the mid-luteal phase in both patients and controls. Seventeen out of the 32 patients with idiopathic RIF and only one of the controls had >250 CD56 cells per high power field 400 in endometrial biopsy (p<0.001). The percentage of blood NK cells out of the total lymphocyte population was higher in women with idiopathic RIF (13.41.2%; range, 2.63-29.01) than in controls (8.40.7%; range, 5.72-13.28; p=0.026). There was a positive correlation between blood and endometrial CD56 cells (=0.707; p<0.001). No significant differences were found between patients with other types of RIF and controls. This study suggested that testing for NK cells might be useful in women with idiopathic RIF during the mid-luteal phase.

Meamar M.,University of Florence | Zribi N.,University of Florence | Cambi M.,University of Florence | Tamburrino L.,University of Florence | And 8 more authors.
Fertility and Sterility | Year: 2012

Objective: To analyze the effect of cryopreservation on sperm DNA fragmentation (SDF) in two cytometric sperm populations, PI brighter and PI dimmer, and to test the effects of Opuntia ficus-indica (OFI) extracts, which contain antioxidants and flavanoids, and of resveratrol on cryopreservation of human semen. Design: In vitro prospective study. Setting: Institutional study. Patient(s): Twenty-one normozoospermic men undergoing semen analysis for couple infertility. Intervention(s): Cryopreservation using the routine method in the presence of OFI extracts or resveratrol. Main Outcome Measure(s): Measurment of SDF by TUNEL/PI flow cytometric method to evaluate sperm motility (by automated motion analysis, CASA system) and viability (by eosin/nigrosin staining) in the two populations of sperm PI br and PI dim. Result(s): Cryopreservation induced an increase of SDF only in the PI br sperm population. The increase was negatively dependent on the basal values of SDF in the same population. Addition of OFI extracts and resveratrol to the cryopreservation medium slightly but statistically significantly reduced SDF in the PI br population without affecting the deleterious effect of cryopreservation on sperm motion parameters or viability. Conclusion(s): The increase of SDF in the PI br population, which is unrelated to semen quality, suggests that caution must be taken in using cryopreserved semen, as morphologically normal and motile sperm may be damaged. The addition of substances with multifunctional properties such as OFI extracts to cryopreservation medium is only slightly effective in preventing the dramatic effects on SDF. Copyright © 2012 American Society for Reproductive Medicine, Published by Elsevier Inc.

Herrlin S.V.,Herrlin Invest | Wange P.O.,Karolinska Institutet | Lapidus G.,Unilabs | Hallander M.,Karolinska Institutet | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: The aim of this prospective randomized intervention study was to evaluate the outcome at a 2 and 5 year follow-up whether combined arthroscopic surgery followed by exercise therapy was superior to the same exercise therapy alone when treating non-traumatic, degenerative medial meniscal tears. Methods: Ninety-six middle-aged patients with MRI-verified degenerative medial meniscus tear and radiographic osteoarthritis grade ≤1 (Ahlbäck) participated in the study. Radiographic examination was done before randomization and after 5 years. The patients were randomly assigned to either arthroscopic treatment followed by exercise therapy for 2 months or to the same exercise therapy alone. At the start of the study and at the follow-ups at 24 and 60 months the patients answered three questionnaires KOOS, Lysholm Knee Scoring Scale and Tegner Activity Scale and made pain ratings on the Visual Analogue Scale (VAS). Results: Both groups showed highly significant clinical improvements from baseline to the follow-ups at 24 and 60 months on all subscales of KOOS, Lysholm Knee Scoring Scale and VAS (p < 0. 0001). No group differences were found at any of the testing occasions. One third of the patients that were treated with exercise therapy alone did not feel better after the treatment but were improved after arthroscopic surgery. According to radiographic findings two patients from each group had a slight progression of their osteoarthritis after 5 years. Conclusion: The findings indicate that arthroscopic surgery followed by exercise therapy was not superior to the same exercise therapy alone for this type of patients. Consequently, exercise therapy can be recommended as initial treatment. However, one third of the patients from the exercise group still had disabling knee symptoms after exercise therapy but improved to the same level as the rest of the patients after arthroscopic surgery with partial meniscectomy. Level of evidence: I. © 2012 Springer-Verlag.

PubMed | Unilabs, Lund University, Sahlgrenska Academy, Karolinska University Hospital and Gothenburg University
Type: Journal Article | Journal: Scandinavian journal of gastroenterology | Year: 2016

OBJECTIVE Histological evaluation of intestinal biopsies for the diagnosis of coeliac disease can be challenging and compatible with risk of misdiagnosis. The aim was to evaluate the agreement of pathological diagnosis for coeliac disease in children investigated at four major paediatric university hospitals in Sweden. MATERIALS AND METHODS Intestinal duodenal biopsies were collected from 402 children at median 9.7 years (1.4-18.3 years). A pathologist at each hospital performed the primary evaluation. A designated pathologist, blinded to the primary evaluation, performed a second Marsh classification of biopsies (M0 to M3c) taken from the bulb and duodenum separately. Kappa () scores between first and second evaluation determined the agreement. Plasma samples were collected at the day of intestinal biopsy and analysed for tissue transglutaminase autoantibodies (tTGA) using radioligand-binding assays. RESULTS Marsh scores were concordant in 229/356 biopsies (64%, = 0.52, p < 0.0001). Among discordant results, 15/127 (12%) showed M0 in distal duodenum but M2 in the bulb, whereas the opposite was true for 8/127 (6%) of the biopsies. There were fewer collected duodenal biopsies, more missing bulb biopsies and missing CD3 staining among discordant evaluations. The second evaluation revealed a Marsh score compliant with coeliac disease in 22 children of whom seven children were tTGA positive. CONCLUSIONS The variation between university hospitals on the pathological evaluation of biopsies may lead to misdiagnosis of coeliac disease in paediatric patients. Access to clinical and endoscopic information as well as tTGA levels may be useful for the pathologist to complement the evaluation in dubious cases.

Jonsson K.,Unilabs | Claesson B.E.B.,Unilabs | Hedelin H.,Unilabs
Scandinavian Journal of Urology and Nephrology | Year: 2011

Objectives. To survey the bacterial flora and antibiotic resistance in urinary strains from patients with indwelling bladder catheters residing in nursing homes within a geographically defined region. Material and methods. Urine was sampled for culture from 163 catheter patients (126 men and 37 women) during a 2 week period in March 2010. Susceptibility testing of the isolated bacteria was compared with all urinary strains (n = 9994) from hospitals and primary healthcare in the same geographical area cultured during the first 6 months of 2010 (control group). Results. Bacteriuria was found in 159 of 163 urine samples (98%). Enterococcus faecalis and Escherichia coli were the most common species, one or both being detected in 72% of the urine samples, while Proteus species were found in10% and a single isolate of Providentia species was seen.Strains in the study patients were more resistant to antibiotics than in the control group. Particularly large differences were noted for ciprofloxacinin in E. coli (16.9% vs 7.9%) and for trimethoprimsulfamethoxazole in E. faecalis (39.1% vs 24.8%). One extended spectrum β-lactamase (ESBL)-producing E. coli was cultured (1.3%), compared with 1.6% in the control group. No vancomycin-resistant enterococci (VRE) or methicillin-resistant Staphylococcus aureus (MRSA) were detected. Conclusions. Proteus mirabilis and Providentia species were rarely isolated, in sharp contrast to previous studies from geriatric hospital wards where they have often been in the majority. The limited incidence of ESBL and the absence of VRE and MRSA is gratifying, but the high resistance to antibiotics needs to be assessed on a continuous basis. © 2011 Informa Healthcare.

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