THE UTILITY OF PGT VS NON-PGT FROZEN EMBRYO TRANSFER BY PATIENT AGE GROUP

Abstract Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

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SAT-168 Adrenal Incidentalomas: Impact of Patient Age on Referral Rates for Endocrine Evaluation

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1042 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Anthony Fryer ◽

Sarah Hancock ◽

Cherian George ◽

Basil George Issa ◽

Simon Lea ◽

...

Keyword(s):

Age Groups ◽

Adrenal Incidentaloma ◽

Older Age ◽

Age Group ◽

Adrenal Incidentalomas ◽

Patient Age ◽

Radiology Reports ◽

Patient Âgé ◽

Mri Scans ◽

Ct And Mri

Abstract It is estimated that the prevalence of adrenal incidentaloma increases with age: ~3% of those aged 50 years, rising to 10% in those >70 years (1). Given the aging population together with increased utilisation of cross-sectional imaging in the UK (eg CT urogram, MR angiogram), we explored the proportion of patients with adrenal incidentaloma by age based on current imaging trends. Furthermore, there is no information currently available on the relationship between age and pattern of endocrine referrals. We extracted data for all CT and MRI scans from Jan 2018-Oct 2019 and used key phrases in radiology reports (eg adrenal adenoma/lesion/mass/nodule/incidentaloma, incidental adrenal, indeterminate adrenal) to identify potential lesions. We also extracted data on patient age and referral patterns as identified by a logged referral or an attendance (new or follow-up) to endocrine clinic 3 months post index scan, stratified by 10 year age groups. Where possible, we excluded false hits (eg no adrenal lesion). Preliminary data showed that, of the 2604 potential lesions identified by CT and MRI scans, 78.7% were on patients aged over 60 years. The numbers of identified lesions gradually increased with age to a peak in the 71-80 year age group after which these declined. Whilst patients younger that 60 years had fewer potential lesions identified, they were more likely to be referred to endocrine services (73 out of 55 patients; 13.2%) than those in the older age group (168 out of 2049; 8.2%; p<0.001). Indeed there was a statistically significant trend towards decreasing referral with age group (Chi-squared test for trend; p<0.001). In conclusion, patients over 60 years have a higher number of potential adrenal incidentalomas. However, this group is less likely to be referred for endocrine evaluation. This is particularly concerning given the large number of scans requested and the higher prevalence of incidentalomas in this age group. This study represents preparatory work on innovations to enhance case detection, particularly in the older age groups (2). 1. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline. Eur J Endocrinol. 2016;175:G1-G34 2. Hanna FWF, Issa BG, Lea SC, George C, Golash A, Firn M, Ogunmekan S, Maddock E, Sim J, Xydopoulos G, Fordham R, Fryer AA. Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness. BMJ Open Quality. 2019;In press.

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Distribution of SARS-CoV-2 PCR Cycle Threshold Values Provide Practical Insight Into Overall and Target-Specific Sensitivity Among Symptomatic Patients

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa133 ◽

2020 ◽

Vol 154 (4) ◽

pp. 479-485 ◽

Cited By ~ 4

Author(s):

Blake W Buchan ◽

Jessica S Hoff ◽

Cameron G Gmehlin ◽

Adriana Perez ◽

Matthew L Faron ◽

...

Keyword(s):

Viral Load ◽

Limit Of Detection ◽

False Negative ◽

Age Group ◽

Rt Pcr ◽

Patient Age ◽

Cycle Threshold ◽

Negative Results ◽

Patient Âgé ◽

False Negative Results

Abstract Objectives We examined the distribution of reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (CT) values obtained from symptomatic patients being evaluated for coronavirus disease 2019 (COVID-19) to determine the proportion of specimens containing a viral load near the assay limit of detection (LoD) to gain practical insight to the risk of false-negative results. We also examined the relationship between CT value and patient age to determine any age-dependent difference in viral load or test sensitivity. Methods We collected CT values obtained from the cobas severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay corresponding to 1,213 combined nasopharyngeal-oropharyngeal specimens obtained from symptomatic individuals that were reported as positive or presumptive positive for SARS-CoV-2. CT values were stratified by SARS-CoV target and patient age group. Results In total, 93.3% to 98.4% of specimens demonstrated CT values greater than 3× the assay LoD, at which point false-negative results would not be expected. The mean of CT values between age groups was statistically equivalent with the exception of patients in age group 80 to 89 years, which demonstrated slightly lower CTs. Conclusions Based on the distribution of observed CT values, including the small proportion of specimens with values near the assay LoD, there is a low risk of false-negative RT-PCR results in combined nasopharyngeal-oropharyngeal specimens obtained from symptomatic individuals.

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Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: a retrospective study in 379 patients.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.9.3129 ◽

1997 ◽

Vol 15 (9) ◽

pp. 3129-3140 ◽

Cited By ~ 175

Author(s):

K Lote ◽

T Egeland ◽

B Hager ◽

B Stenwig ◽

K Skullerud ◽

...

Keyword(s):

Prognostic Factors ◽

Median Survival ◽

Tumor Resection ◽

Low Grade Glioma ◽

World Health ◽

Symptom Duration ◽

Low Grade ◽

Age Group ◽

Patient Age ◽

Patient Âgé

PURPOSE We report survival, prognostic factors, and treatment efficacy in low-grade glioma. PATIENTS AND METHODS A total of 379 patients with histologic intracranial low-grade glioma received post-operative radiotherapy (n = 361) and intraarterial carmustine (BCNU) chemotherapy (n = 153). Overall survival and prognostic factors were evaluated with the SPSS statistical program (SPSS Inc, Chicago, IL). RESULTS Median survival (all patients) was 100 months (95% confidence interval [CI], B7 to 113); in age group 0 to 19 years (n = 41), 226 months; in age group 20 to 49 years (n = 263), 106 months; in age group 50 to 59 years (n = 49), 76 months; and for older patients (n = 26), 39 months. Projected survival at 10 and 15 years was 42% and 29%, respectively. Patient age, World Health Organization (WHO) performance status, tumor computed tomography (CT) contrast enhancement, mental changes, or initial corticosteroid dependency were significant independent prognostic factors (p < .05), while histologic subgroup, focal deficits, presence of seizures, prediagnostic symptom duration, tumor category, and tumor stage were not. Patients aged 20 to 49 years with no independent negative prognostic factors (n = 132) had a median survival time of 139 months versus 41 months in patients with two or more factors (n = 33). Patients who presented with symptoms of expansion (n = 97) survived longer when resected (P < .03); otherwise no survival benefit was associated with initial tumor resection compared with biopsy. Intraarterial chemotherapy and radiation doses more than 55 Gy were not associated with prolonged survival. Among 66 reoperated patients, 45% progressed to high-grade histology within 25 months. CONCLUSION Prognosis in low-grade glioma following postoperative radiotherapy seems largely determined by the inherent biology of the glioma and patient age at diagnosis.

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Partial Suture Fusion in Nonsyndromic Single-Suture Craniosynostosis

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620902299 ◽

2020 ◽

Vol 57 (4) ◽

pp. 499-505

Author(s):

Michael K. Boyajian ◽

Hanny Al-Samkari ◽

Dennis C. Nguyen ◽

Sybill Naidoo ◽

Albert S. Woo

Keyword(s):

Fusion Rate ◽

Cranial Sutures ◽

Complete Fusion ◽

Age Group ◽

Diagnostic Significance ◽

Patient Age ◽

Patient Âgé ◽

Partial Fusion ◽

Suture Fusion ◽

Single Suture

Introduction: Partial synostosis of cranial sutures has been shown to have clinical and diagnostic significance. However, there is limited published information about how suture fusion progresses over time. In this study, we evaluate patients with nonsyndromic single-suture synostosis. We aim to define the incidence of partial versus complete suture fusion and whether a correlation exists between the degree of suture fusion and age. Methods: Two hundred fifty-four patients with nonsyndromic single-suture synostosis were evaluated. Preoperative computed tomography (CT) scans were rendered in 3-dimensions, all sutures were visualized and assessed for patency or fusion, and length of fusion was measured. Findings were grouped according to suture type (sagittal, coronal, metopic, or lambdoid), the degree of fusion (full, >50%, or <50%), and patient age at time of CT scan (0-90, 91-180, 181-360, or >360 days). Data were analyzed to correlate patient age versus the degree of suture fusion. Results: For all patients, 72% had complete and 28% had partial synostosis. Ratios of full to partial fusion for each suture type were as follows: sagittal 97:36, coronal 35:22, metopic 46:4, and lambdoid 4:10. The sagittal, coronal, and metopic groups demonstrated greater probabilities of complete suture fusion as patient age increases ( P = .021, P < .001, P = .001, respectively). This trend was also noted when all sutures were considered together by age-group ( P < .001). Conclusion: We note a partial suture fusion rate of 28.3%. Our analysis shows a correlation between the extent of suture synostosis and patient age. Finally, we demonstrate that different sutures display different patterns of partial and complete fusion.

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Does Advancing Maternal Age Ameliorate the Advantage of Blastocyst Transfer?: The Implantation Rate of Blastocyst Compared to Cleavage Stage Embryo Transfer as a Function of Patient Age

Fertility and Sterility ◽

10.1016/j.fertnstert.2011.01.071 ◽

2011 ◽

Vol 95 (4) ◽

pp. S13-S14

Author(s):

R. Buyalos ◽

M. Li ◽

A. Kumar ◽

G. Hubert ◽

F. Miller

Keyword(s):

Embryo Transfer ◽

Maternal Age ◽

Implantation Rate ◽

Blastocyst Transfer ◽

Cleavage Stage ◽

Patient Age ◽

Patient Âgé ◽

Cleavage Stage Embryo ◽

Stage Embryo

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303 INDUCED MOTILITY OF MESA/TESE SPERMATOZOA IS ASSOCIATED WITH INCREASED FERTILIZATION AND IMPLANTATION RATES IN HUMAN

Reproduction Fertility and Development ◽

10.1071/rdv18n2ab303 ◽

2006 ◽

Vol 18 (2) ◽

pp. 259 ◽

Cited By ~ 1

Author(s):

H. L. Zheng ◽

L. J. Fengand

Keyword(s):

Embryo Transfer ◽

Sperm Motility ◽

Testicular Sperm Extraction ◽

Obstructive Azoospermia ◽

Patient Age ◽

Nutritional Elements ◽

Group I ◽

Patient Âgé ◽

Implantation Rates ◽

Group Ii

The key for human IVF using the intracytoplasmic sperm injection (ICSI) procedure is to find moving and living sperm in azoospermic men. The objective of this study was to determine the effect of induced sperm motility on the fertilization and implantation rates in humans. Testicular sperm extraction (TESE) medium containing sperm stimulators and nutritional elements is specially designed for male factor and/or poor quality sperm with lower motility. Men with obstructed or absent ejaculatory ducts were treated by using a microepididymal sperm aspiration (MESA) procedure. Sperm are aspirated directly from the epididymis for use in the ICSI procedure. Men with non-obstructive azoospermia were treated by using the TESE procedure. Small samples of testicular tissue are obtained by needle or microsurgical biopsy and a few sperm are painstakingly dissected out of the tissue for use in the ICSI procedure. Sperm specimens either from epididymis or testis were divided into the two respective groups. In Group I, the specimens were washed in a TESE medium plus 10% human serum albumin (HSA), and then incubated with TESE medium containing 10% HSA in a 5% CO2 incubator to induce sperm motility. In Group II, the specimens were washed in human tubal fluid (HTF) medium plus 10% HSA, and then incubated with HTF containing 10% HSA in a 5% CO2 incubator. After 1 h of incubation, the motility of spermatozoa was evaluated under a microscope. The ICSI procedure was performed under an inverted microscope. Fertilized eggs were cultured in HTF medium containing 10% serum substitute supplement (SSS) until Day 3 for embryo transfer. Patients' pregnancy was followed after embryo transfer. This study demonstrated that incubation of spermatozoa from MESA and TESE procedures in TESE medium, as compared with HTF medium, results in significantly increased sperm progression (MESA sperm: 2-3 vs. 0-1; TESE sperm: 1-1.5 vs. 0-0.1) and motility (MESA sperm: 12.0 � 1.8% vs. 3.3 � 0.5%; TESE sperm: 4.5 � 0.2% vs. 0.15 � 0.02%) all respectively. Induced motility of spermatozoa in TESE medium, as compared with HTF medium, is associated with a significantly increased fertilization rate (MESA sperm: 74.5 � 3.5% vs. 60.2 � 3.1; TESE sperm: 73 � 4.3% vs. 48.4 � 3.7%) and implantation rate (MESA sperm: 29.8 � 3.8% vs. 19.4 � 2.7%, for patient age 32 � 3.0, in Group I, n = 13, and in Group II, n = 12; TESE sperm: 23.2 � 3.3% vs. 15.4 � 2.8%, patient age 33 � 2.8%, in Group I, n = 11, and in Group II, n = 9), and significantly decreased the ICSI performing time (30 � 10 vs. 120 � 20 min), all respectively. TESE medium can significantly increase the motility of spermatozoa from TESE/MESA, because it contains specific sperm stimulators and nutritional elements that directly resulted in the increase of fertilization and implantation rates.

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