Time-lapse cleavage rating predicts human embryo viability.

Chronology of three consecutive mitotic events in human pre-implantation embryos was examined by time-lapse imaging. In zygotes producing well-formed and pregnancy-yielding expanded blastocysts, uniform time-patterning of cleavage clusters (c) and interphases (i) was revealed: i2=11+/-1, i3=15+/-1, i4=23+/-1 h / c2=15+/-5, c3=40+/-10, c4=55+/-15 min. Oppositely, shortened or prolonged durations of one or more cell cycles were strongly predictive of poor implantation and development. Furthermore, trichotomic mitosis was discovered in 17 % of cases - zygotes cleaved into 3 blastomeres and 2-cell embryos into 5-6 cells (instead of normal 2 and 4). During conventional clinical assessment, such embryos are indistinguishable from normal, often considered just-in-course of the next cell cycle. Only detailed time-lapse monitoring paced at 10-minute intervals had proven all these embryos to be absolutely unviable, even in rare cases when they reduced their hypercellularity to normal cell counts via cell-cell fusion. Overall, we demonstrate that time-lapse embryo cleavage rating (ECR) as a standalone diagnostic procedure allows for effective identification of viable early embryos with 90 % specificity, while elimination of good-looking but unviable embryos can be assumed with a specificity of 100 %. Thus, making this non-invasive and contactless approach worth of addition to routine embryo screening in clinical IVF programs.

Paradoxes in medicine: an access to new knowledge?

The analysis of health and nutrition data from various countries shows many surprising and seemingly incomprehensible facts and paradoxical relationships. Health status of a country is the result of long-term factors and therefore it cannot be changed from day to day. For example in Central European countries there was a sudden increase in life expectancy after the fall of Soviet hegemony. French paradox is the oldest example of apparent contrast between "unhealthy" nutrition and low cardiovascular mortality. Although, the consumption of animal fat and milk and milk products in Switzerland is very high, but premature cardiovascular mortality of Swiss men and women is the lowest in Europe. In USA there is concominant increase of obesity and decrease in cardiovascular mortality. In Cuba, in spite of great economic problems its relatively high male and female life expectancy is very similar to the rich USA. The life expectancy in Albania is significantly higher than in many countries in Central Europe and in the Balkan region, in spite of the fact that Albania remains the poorest European country. Analysis of these unexpected and paradoxical relations indicate the importance of the quality of medical care, control of cardiovascular risk factors (USA) and the influence of modest but biologically balanced diet on low prevalence of cardiovascular disease in Cuba and Albania. The experience from former communist Central European countries suggests important influence of chronic stress and psychosocial factors on heart diseases and life expectancy. These paradoxes open the door to new information (Fig. 5, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

The prevalence of female obesity in the world and in the Slovak Gypsy women.

OBJECTIVES: Paper is focused (1) on the comparison of some parameters (body height, body weight, blood pressure, BMI values) in Gypsy and non-Gypsy women from eastern and western Slovakia; (2) on the comparison of biochemical parameters in the Gypsy minority and majority of western Slovakia. BACKGROUND: There is not enough of available reliable data on health status of Slovak Gypsy minority. METHODS: Gypsy and non-Gypsy women (57 and 56 subjects) from the western region of Slovakia (Zlate Klasy, Gbely) as well as Gypsy and non-Gypsy women (393 and 444 subjects) from the eastern region of Slovakia (Presov region) were investigated. Values of body height, body weight, blood pressure and calculated values of BMI (body mass index) were performed. Biochemical parameters of 269 Gypsies and 346 non-Gypsy persons from western Slovakia were measured. The statistically significant cut-off point was p < 0.05. RESULTS: In all age groups, the BMI values of Gypsy women were higher than those of non-Gypsy women. The occurrence of obesity, overweight, and hypertension was higher in the Gypsy population from both eastern and western regions of Slovakia. In the group of Gypsy minority of western Slovakia, the parameters of metabolic syndrome (dyslipidemia--high concentrations of triglycerides, low concentrations of HDL cholesterol, high concentrations of fasting insulin, and high values of insulin resistance) were found to be significantly changed. CONCLUSION: These findings suggest that the risk of atherogenesis in Gypsy minority has considerably increased and this is caused by unfavourable factors such as an increase in the prevalence of obesity, hypertension, smoking and the deficiency in protective substances leading to dyslipidemia, hyperinsulinemia, cardiovascular diseases, metabolic syndrome and diabetes (Fig. 2, Tab. 4, Ref 10). Full Text (Free, PDF) www.bmj.sk.