Variable aneuploidy mechanisms in embryos from couples with poor reproductive histories undergoing preimplantation genetic screening.

BACKGROUND: Preimplantation genetic screening (PGS) is used to determine the chromosome status of human embryos from patients with advanced maternal age (AMA), recurrent miscarriage (RM) or repeated implantation failure (RIF). METHODS: Embryos from 47 such couples were investigated for chromosomes 13, 15, 16, 18, 21 and 22 using fluorescence in situ hybridization with two rounds of hybridization. The investigation included parental lymphocyte work-up, the screening of blastomeres on day 3 and full follow-up on day 5/6 of untransferred embryos. RESULTS: The outcome of 60 PGS cycles is described, in which 523 embryos were biopsied; 91% gave results, of which 18% were diploid for all the chromosomes tested and 82% were abnormal. The pregnancy rate per cycle that reached the biopsy stage was 27%, and 30% per embryo transfer. Satisfactory follow-up was obtained from 353 embryos; all those diagnosed as abnormal were confirmed as such, although two false-positives were detected in relation to specific chromosome abnormalities. Meiotic errors were identified in 16% of embryos. Between the RM, AMA and RIF groups, there was a significant difference in the distribution of embryos that were uniformly abnormal and of those with meiotic errors; with an almost 3-fold increase in meiotic errors in the first two groups compared with the RIF group. CONCLUSIONS: This complete investigation has identified significant differences between referral groups concerning the origin of aneuploidy in their embryos.

Shyness, friendship quality, and adjustment during middle childhood.

Whereas many young children show initial wariness on meeting a stranger, shyness that lasts into middle childhood may be indicative of concurrent problems and subsequent disorder. Adjustment problems of an internalising nature, such as low self-esteem, loneliness, and anxiety may occur. Special significance has, however, been ascribed to preadolescent friendships as a means of validating self-worth and buffering against loneliness and anxiety. The main aim of the present study is to examine associations between shyness, perceptions of friendship quality, and indices of adjustment related to internalising problems. The study involves a sample of 8.4-10.6-year-olds (N = 50), preselected at 4.5 years to include a high proportion of shy children. Ratings of shyness to an unfamiliar adult had been made by different observers at 4.5 and 7 years, and at the present ages by another observer, mothers, and teachers. Observer-rated shyness was highly consistent over time and was significantly correlated with mothers' and teachers' ratings, although both significantly underestimated children's shyness relative to observer ratings. Compared with the younger children (mean age of 9 years), observed shyness (a composite over all three age points) increased in salience for the older children (mean age of 10 years), becoming significantly correlated with trait anxiety as well as low global self-worth. Indeed, global self-worth took on a central role for the older children, showing significant correlations not only with observed shyness and internalising problems (loneliness and anxiety), but also with perceptions of social acceptance and classmate support as well as friendship quality, with a named "best friend". Thus by 10 years of age, aspects of peer relationships may influence and be influenced by global self-worth, with a possible buffering effect on any potential detrimental effects of shyness.

Controlled trial of standard pad and bell alarm against mini alarm for nocturnal enuresis.

Fifty six children aged from 6-16 years who wet their beds at night were entered into a controlled trial of two alarm devices: a traditional alarm using a wet sensor mat on the bed attached to an alarm bell out of reach of the child, and a mini alarm system incorporating a tiny perineal wet sensor attached to a small alarm worn on the child's clothing. A quota allocation system ensured comparability between the two treatment groups. The children were encouraged to use the alarm for four months. Both alarms were equally effective in helping children to become dry. There was no significant difference between the number of children unable to comply with treatment or to be helped by each alarm. The rate of acquisition of dryness was similar for the two groups. The traditional standard alarm was sturdier, more dependable, and easier to maintain, but the mini alarm had some advantages, particularly for girls. Both types of alarm are recommended for general use.

Meningioma presenting as an intraoral mass.

The following case report illustrates a rather rare oral lesion, an extracranial meningioma. In the dental office the lesion was seen on a periapical x-ray film as a multilocular radiolucency. The patient, however, could not be convinced of the necessity of biopsy until several years later when clinical expansion of the maxillary buccal plate was noted. Thereafter, clinical, radiographic, and histopathologic examination revealed a diffuse meningioma involving the maxillary sinus, the floor of the nose, and the maxillary gingiva. The patient has since refused complete surgical removal but remains alive and well 8 years after the lesion was first noted.