943 resultados para recipient


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Objective: This prospective randomized trial evaluated if there is an improvement in clinical outcomes when assisted hatching is performed in embryos derived from vitrified oocytes in an ovum donation program. Methods: Sixty oocyte recipients undergoing donation program using egg-cryobanking were randomly allocated to the assisted hatched (AH, n=30) or control group (n=30). Pregnancy and implantation rates were compared between the groups. Vitrification and warming procedure were carried out according to the Cryotopmethod. Immediately before embryo transfer, embryos undergoing laser-assisted hatching had the zona pellucida thinned using a 1.48 μm wavelength diode laser. Results: A total of 288 vitrified MII oocytes were warmed for the 60 recipients (4.8 oocytes per recipient). Out of 288 vitrified oocytes, 273 (94.8%) survived. All surviving oocytes were sperm injected and 228 displayed 2 pronucleus 16-18h after injection (83.5%). There were 172 good quality embryos transferred. Twenty four patients achieved clinical pregnancy (total pregnancy rate of 40%). The clinical pregnancy rate did not differ between AH and control groups (44.4% and 33.3%, respectively, p=0.1967), however AH resulted in a significant higher implantation rate (31.6% and 18.4%, p=0.0206). These findings were confirmed by the regression models either for pregnancy (OR = 1.14; IC 95% = 0.80-.72; p= 0.766), as for the implantation rate (RC:19.45, P=0.041). Conclusions: Our evidences demonstrated the effectiveness of the AH in embryos derived from warmed oocytes and suggest that oocyte cryopreservation is a valuable tool to provide successful outcomes in an egg donor program. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.

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A laboratory culture of Ankistrodesmus gracilis algae was evaluated by studying the biology of the species and its chemical composition in a traditional medium (CHU 12) and in two alternative culture media, NPK (20-5-20) and macrophyte (Eichhornia crassipes) + NPK, in three different types of recipients (fiberglass, carboy and plastic bag). First peak in the growth curve of Ankistrodesmus gracilis occurred on the ninth day in macrophyte + NPK medium (74.16 x 10 5 cells mL -1) in a fiberglass recipient. However, highest density (p < 0.01) was reported in medium CHU 12 (122.87 x 10 5 cells mL -1) in a plastic bag on the twelfth day. Cell density was over 70 x 10 5 cells mL -1 starting on the twelfth day. Growth rate of A. gracilis was similar (p > 0.05) in culture media in the three recipients. Protein and fiber were similar (p > 0.05) in the treatments, but lipids were higher (p < 0.05) in NPK. Nitrate, ammonia, total phosphorus and orthophosphate contents were over 1 mg L -1 in NPK (p < 0.01). Results show that alternative media, such as NPK and macrophyte + NPK, are possible for large-scale culture of A. gracilis cultured in three types of recipients. Costs are low, occupying less space when cultured in plastic bags and in the laboratory.

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Background: Throughout dairy cows evolution, milk production was always the key point to select the superior animal. Currently, several evidences has shown that high milk production have intensively contributed to the decline of dairy cattle fertility. Beyond milk production, dairy cows have their reproductive performance impaired by another factors, heat stress and repeat-breeding. Methods like fixed time artificial insemination and embryo transfer were developed to minimize the effects of these factors, and improve dairy herds profitability. This review aims to show some key-point experiments conducted to improve the efficiency of the self-appointed protocols for artificial insemination and embryo transfer in Brazil, overcoming several reproductive problems. Our goal is to develop cheap and easy self-appointed programs that facilitate animal handling and maximize their reproductive outcomes all over the year. Review: Failure in estrus detection is the mainly limiting factor for the use of artificial insemination in high-production dairy herd. An excellent alternative to overcome the need of estrus detection is fixed time artificial insemination. Many protocols with and without the use of estradiol have been developed to that end. Among the protocols for fixed time artificial insemination without estradiol, DoubleOvsynch has been extensively used recently in American dairy herds. In Brazil, similar pregnancy rate was obtained compared to progesterone-estradiol based protocols for fixed time artificial insemination. Particularities of progesterone-estradiol based protocols as (1) new progesterone device or devices previously used for eight days; (2) different doses of eCG; and (3) the use of estradiol cypionate for fixed time artificial insemination have been studied in Brazil. The use of self-appointed artificial insemination also enabled the reduction of the interval calving-conception compared to cows inseminated following the standing estrus. Regarding the low fertility of repeat breeders and the effect of heat stress at early pregnancy, other methods like embryo transfer became important tools to enhance reproductive efficiency of Brazilian dairy herds. Protocols were also developed to allow fixed time embryo transfer, eliminating the need of estrus detection and improving the reproductive efficiency of lactating recipients. As well as described for fixed time artificial insemination treatments, there is a large variety of hormone combination for fixed time embryo transfer (with and without estradiol). An experiment conducted in Brazil demonstrated that protocols for fixed time embryo transfer without estradiol can be as good as with estradiol to synchronize high-producing Holstein recipients, essentially during summer. Particularities related to embryos cryopreservation, synchronization of the estrus cycle of donors and recipients and the site of embryo release into the uterine horn were also investigated. Greater conception rates were achieved when fresh embryos were transferred compared to frozen-thawed ones. Also, the tight synchronization between donor and recipient (same day of estrus) resulted more pregnancies than when recipients were one day later or in advantage in relation to donors. Moreover, the site of embryo release into the uterine horn (ipsilateral to the corpus luteum) had no effect on pregnancy rates after in vivo produced embryo transfer. Conclusion: Both fixed time artificial insemination and fixed time embryo transfer are important tools to improve reproductive efficiency of high-producing dairy cows. These biotechnologies help bypassing some of the greatest challenges of dairy cattle reproduction: the difficulties of estrus detection, and the low fertility associated to heat stress and repeat breeding.

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The purpose of this article was to report a series of 23 renal transplant recipients with histologically proven and immunohistochemically confirmed cytomegalovirus (CMV) lesions in the gastrointestinal tract (GIT) and to assess the risk factors associated with severe disease/mortality. CMV patients (n=23) were allocated into two groups: those who died (n=6) and those considered cured (n=17). Overall mortality rate was 26% (6/23). Initial symptoms suggestive of lower GIT involvement were observed in all death cases and in 35.3% of those cured (p=0.01). Enterorrhagia was seen in 83.3% of the patients who died. Death risk increased twofold (RR 2 [1.13-3.52], p=0.01) when symptoms of lower GIT involvement were initially observed and sixfold when enterrohagia was present (RR 6 [1.1-35.9], p=0.001). Among death cases, mean time at diagnosis was significantly more distant (2002±2.9×2008±1.6, p=0.04). The difference in mortality rates seen as service practices changed along the years demonstrates the importance of early diagnosis. © 2011 John Wiley & Sons A/S.

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Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

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This article presents a case report of autogenous tooth transplantation to the site of the fissure, in addition to bone augmentation with graft of autogenous bone harvested from the iliac crest, performed in a cleft palate patient, who had insufficient bone volume. A non-syndromic 10-year-old girl, with a unilateral cleft lip and palate, incisal transforamen fissures, agenesis of the maxillary left central incisor and both maxillary lateral incisors, was treated with autogenous bone graft in the cleft area. The orthodontic treatment plan was to replace the missing lateral incisors with the maxillary canines and to extract the mandibular first premolars. One of the mandibular premolars was extracted from its site with 2/3 of its root formation completed and transplanted to the maxillary left central incisor area. After orthodontic treatment, the anatomic crowns were characterized with composite resin. Autogenous tooth transplantation can be performed in the area of the fissure in young cleft palate patients, by performing bone graft augmentation before transplantation of the tooth, to gain sufficient recipient alveolar bone volume. A multidisciplinary approach is mandatory for the success of this clinical procedure, especially in cleft palate patients. © 2012 John Wiley & Sons A/S.

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Background: The bone tissue responses to Cyanoacrylate have been described in the literature, but none used N-butyl-2-cyanoacrilate (NB-Cn) for bone graft fixation. Purpose: The aims of the study were: (a) to analyze the bone grafts volume maintenance fixed either with NB-Cn or titanium screw; (b) to assess the incorporation of onlay grafts on perforated recipient bed; and (c) the differences of expression level of tartrate-resistant acid phosphatase (TRAP) protein involved in bone resorption. Materials and Methods: Eighteen New Zealand White rabbits were submitted to calvaria onlay grafting on both sides of the mandible. On one side, the graft was fixed with NB-Cn, while on the other hand the bone graft was secured with an osteosynthesis screw. The computed tomography (CT) was performed just after surgery and at animals sacrifice, after 1 (n=9) and 6weeks (n=9), in order to estimate the bone grafts volume along the experiments. Histological sections of the grafted areas were prepared to evaluate the healing of bone grafts and to assess the expression of TRAP protein. Results: The CT scan showed better volume maintenance of bone grafts fixed with NB-Cn (p≤0.05) compared with those fixed with screws, in both experimental times (analysis of variance). The immunohistochemical evaluation showed that the TRAP expression in a 6-week period was significantly higher compared with the 1-week period, without showing significant difference between the groups (Wilcoxon and Mann-Whitney). Histological analysis revealed that the NB-Cn caused periosteum damage, but provided bone graft stabilization and incorporation similar to the control group. Conclusion: The perforation provided by screw insertion into the graft during fixation may have triggered early revascularization and remodeling to render increased volume loss compared with the experimental group. These results indicate that the NB-Cn possesses equivalent properties to titanium screw to be used as bone fixation material in osteosynthesis. © 2010 Wiley Periodicals, Inc.

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Aim: The first aim of the present experiment was to compare bone healing at implants installed in recipient sites prepared with conventional drills or a piezoelectric device. The second aim was to compare implant osseointegration onto surfaces with and without dendrimers coatings. Material and Methods: Six Beagles dogs were used in this study. Five implants with two different surfaces, three with a ZirTi® surface (zirconia sand blasted, acid etched), and two with a ZirTi®-modified surface with dendrimers of phosphoserine and polylysine were installed in the right side of the mandible. In the most anterior region (P2, P3), two recipient sites were prepared with drills, and one implant ZirTi® surface and one coated with dendrimers implants were installed at random. In the posterior region (P4 and M1), three recipient sites were randomly prepared: two sites with a Piezosurgery® instrument and one site with drill and two ZirTi® surface and one coated with dendrimers implants installed. Three months after the surgery, the animals were sacrificed for histological analysis. Results: No complications occurred during the healing period. Three implants were found not integrated and were excluded from analysis. However, n = 6 was obtained. The distance IS-B at the buccal aspect was 2.2 ± 0.8 and 1.8 ± 0.5 mm, while IS-C was 1.5 ± 0.9 and 1.4 ± 0.6 mm at the Piezosurgery® and drill groups, respectively. Similar values were obtained between the dendrimers-coated and ZirTi® surface implants. The BIC% values were higher at the drill (72%) compared to the Piezosurgery® (67%) sites. The BIC% were also found to be higher at the ZirTi® (74%) compared to the dendrimers-coated (65%) implants, the difference being statistically significant. Conclusion: This study has revealed that oral implants may osseointegrate equally well irrespective of whether their bed was prepared utilizing conventional drills with abundant cooling or Piezosurgery®. Moreover, the surface coating of implants with dendrimers phosphoserine and polylysine did not improve osseointegration. © 2012 John Wiley & Sons A/S.

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Although the safety of living kidney donation has been well established, prospective studies examining the physical and psychosocial aspects of the donor's quality of life are still scarce. Thus, the purpose of this prospective work was to assess the quality of life of 50 consecutive donors before and after kidney transplantation. All donors were asked to respond to both a donor questionnaire and the short-form 36-item health survey (SF-36). Interviews were individually conducted before, three months after, and over one yr after transplantation. Donation was considered a positive experience by all patients and had no impact on any physical or psychosocial aspect of the donor's life. Improved self-esteem and better quality of life after donation were reported in 52% of the cases. All donors would donate again and encouraged donation. SF-36 data indicated improvement in post-donation mental and physical scores among living donors closely related to recipient. Overall, most donors had a positive experience, felt no changes in quality of life, experienced enhanced self-esteem, would donate again, and recommended donation. © 2012 John Wiley & Sons A/S.