Significant differences in efficiency between two commonly used ionophore solutions for assisted oocyte activation (AOA): a prospective comparison of ionomycin and A23187.

PURPOSE: Despite the success of ICSI in treating severe male factor infertile patients, total fertilization failure (FF) still occurs in around 1-3% of ICSI cycles. To overcome FF, the use of calcium ionophores has been proposed to induce oocyte activation and restore fertilization rates. However, assisted oocyte activation (AOA) protocols and ionophores vary between laboratories, and the morphokinetic development underlying AOA remains understudied. METHODS: A prospective single-center cohort study involving 81 in vitro matured metaphase-II oocytes from 66 oocyte donation cycles artificially activated by A23187 (GM508 CultActive, Gynemed) (n=42) or ionomycin (n=39). Parthenogenesis was induced, and morphokinetic parameters (tPNa, tPNf, t2-t8, tSB, and tB) were compared between the 2 study groups and a control group comprising 39 2PN-zygotes from standard ICSI cycles. RESULTS: Ionomycin treatment resulted in higher activation rates compared to A23187 (38.5% vs 23.8%, p=0.15). Importantly, none of the A23187-activated parthenotes formed blastocysts. When evaluating the morphokinetic dynamics between the two ionophores, we found that tPNa and tPNf were significantly delayed in the group treated by A23187 (11.84 vs 5.31, p=0.002 and 50.15 vs 29.69, p=0.005, respectively). t2 was significantly delayed in A23187-activated parthenotes when compared to the double heterologous control embryo group. In contrast, the morphokinetic development of ionomycin-activated parthenotes was comparable to control embryos (p>0.05). CONCLUSION: Our results suggest that A23187 leads to lower oocyte activation rates and profoundly affects morphokinetic timings and preimplantation development in parthenotes. Despite our limited sample size and low parthenote competence, standardization and further optimization of AOA protocols may allow wider use and improved outcomes for FF cycles.

Comparison of two different oocyte vitrification methods: a prospective, paired study on the same genetic background and stimulation protocol.

STUDY QUESTION: Can two different methods for oocyte vitrification, one using an open tool and the other a closed tool, result in similar oocyte survival rates? SUMMARY ANSWER: The oocyte survival rate was found to be higher in the closed method. WHAT IS KNOWN ALREADY: Open vitrification is performed routinely in oocyte donation cycles. Closed oocyte vitrification may result in slower cooling rates and thus it is less used, even though it has been recommended in order to avoid the risk of cross-contamination between material from different patients. STUDY DESIGN, SIZE, DURATION: This is a prospective cohort study with sibling oocytes carried out in a fertility center between July 2014 and January 2016. The study included 83 oocyte donors each providing a minimum of 12 mature oocytes (metaphase II: MII) at oocyte retrieval. Oocyte survival rate and fertilization rate, as well as reproductive outcomes (biochemical, clinical, ongoing pregnancy and live birth rates) per embryo transfer and also cumulatively between the two methods were compared by Chi2 tests. PARTICIPANTS/MATERIALS, SETTING, METHODS: Donor oocytes were denuded and six MII oocytes from each donor were vitrified using an open method and later assigned to one recipient, while another six MII oocytes were vitrified using a closed method and assigned to a different recipient (paired analysis). ICSI was used in all cases and embryo transfer was performed on Day 2-3 in all cases. MAIN RESULTS AND THE ROLE OF CHANCE: Oocyte donors were 24.8 years old on average (SD 4.7). Recipient age (average 41.2 years, SD 4.7) and BMI (mean 23.8 kg/m2, SD 4.0) were similar between recipient groups. Oocytes vitrified using the closed method had higher survival rate (94.5% versus 88.9%, P = 0.002), but lower fertilization rate (57.1% versus 69.8%, P < 0.001) compared to the open method. The number of fresh embryos transferred in the two groups was 1.8 on average (SD 0.4). Biochemical (45% closed versus 50% open), clinical (40% versus 50%) and ongoing (37.5% versus 42.5%) pregnancy rates were not different between groups (P > 0.05) and neither were live birth rates (37.5% versus 42.5%, P > 0.05). Cumulative reproductive results (obtained after the transfer of all the embryos) were also similar between groups. LIMITATIONS, REASONS FOR CAUTION: The participants of this study were oocyte donors, i.e. young women in good health, and care should be exerted in extending our results to other populations such as infertility patients, oncofertility patients and women freezing oocytes to delay childbearing. WIDER IMPLICATIONS OF THE FINDINGS: Our results suggest that, in spite of different survival and fertilization rates, closed and open oocyte vitrification methods should offer similar reproductive outcomes up to cumulative live birth rates. STUDY FUNDING/COMPETING INTEREST(S): The authors report no conflict of interest. Vitrolife provided the media and the closed method tool needed for the study at no cost.

Trichinella pseudospiralis in the Iberian peninsula.

Nematode worms of the genus Trichinella are zoonotic parasites circulating in most continents, including Europe. In Spain, Trichinella spiralis and Trichinella britovi are highly prevalent in wildlife but seldom in domestic pigs. In Portugal, only T. britovi was documented in wild carnivores. In the period 2006-2013 in Spain, 384 (0.0001%) pigs and 1399 (0.20%) wild boars (Sus scrofa) were positive for Trichinella spp. larvae, which were identified as T. spiralis or T. britovi. In 2014, Trichinella pseudospiralis larvae were isolated from a wild boar hunted in the Gerona province, Cataluña region, North-East of Spain, near the border to France. This is the first report of T. pseudospiralis in the Iberian peninsula, which suggests a broad distribution area of this zoonotic nematode in Europe. Since larvae of this Trichinella species do not encapsulate in the host muscles, they can be detected only by artificial digestion of muscle samples. T. pseudospiralis is the only Trichinella species infecting both mammals and birds. Birds can spread this pathogen over great distances including islands triggering new foci of infections in areas previously considered at low risk for this pathogen.

[The 2009 H1N1 flu pandemic in Navarre, Spain]. / Caracterización de la pandemia de gripe a H1N1 2009 en Navarra.

BACKGROUND: To describe flu activity during the 2009-2010 pandemic in Navarre and compare it to previous seasons. METHODS: An analysis was made of all flu cases reported in primary care and all the virological confirmations made in patients in primary care and in hospitals of Navarre between week 21 of 2009 and week 20 of 2010. RESULTS: Influenza A (H1N1) Virus 2009 was detected in Navarre between week 23 of 2009 and week 2 of 2010, a period when 39 medically diagnosed cases of flu syndrome per 1,000 inhabitants were registered. The epidemic threshold was surpassed in two periods, with a peak in July and a greater one in November. The greatest incidence was reached in children aged between 5 and 14 years (121 per thousand), followed by the group of under fives. There were 224 hospitalisations (36 per 100,000 inhabitants) with confirmation of Influenza A (H1N1) Virus 2009, 8% of whom required admission to intensive care units and there were four deaths (0.6 per 100,000 inhabitants). The rate of hospitalisation was greater amongst children under five (163 per 100,000 inhabitants), while the probability of referral to intensive care increased with age. CONCLUSION: In spite of not having a specific vaccine available until the season was very well advanced, Influenza A (H1N1)Virus 2009 produced a flu wave with similar levels to those of other seasons and its repercussion in hospitalisations and serious cases was moderate.

Molecular differentiation between NS1 gene of a field strain Bluetongue virus serotype 2 (BTV-2) and NS1 gene of an attenuated BTV-2 vaccine.

At the end of September 2000, clinical symptoms of Bluetongue appeared in sheep flocks of the Balearic Islands (Spain). The presence of the BTV serotype 2 in tissue and blood samples of affected animals was confirmed by laboratory techniques. A systematic vaccination were carried out in affected areas using a live monovalent serotype 2 vaccine available from Onderstepoort laboratory (South Africa). In order to perform epidemiological studies, a new method to differentiate between the NS1 genes of BTV-2 affecting the Balearic islands and that of the Onderstepoort commercial live virus vaccine (monovalent, serotype 2) has been developed. This procedure is based on the use of an RT-PCR, followed by restriction endonuclease analysis. Epidemiological data of a study carried out in the period January-October 2001 using this procedure are included.

[Relationship between the number of daily meals and the energy and nutrient intake in the elderly. Effect on various cardiovascular risk factors]. / El número de comidas diarias como condicionante de la ingesta de alimentos energía y nutrientes en ancianos. Influencia en relación con diversos factores de riesgo cardiovascular.

The metabolic consequences of the consumption of a diet depend, in part, on the frequency and distribution of meals. The aim of the present study was to examine the number of meals taken per day by elderly persons, and to analyse the relationship between the number of meals per day on the intake of energy and nutrients, the incidence of obesity/overweight, and different cardiovascular risk factors. Food intake was monitored for five consecutive days using 'precise individual weighing' for institutionalised subjects (n = 58), and by means of a 'food intake record' for independent subjects (n = 92). The number of meals taken per day was recorded, along with anthropometric data, blood pressure and serum lipid and lipoprotein levels. No subject took only one meal per day, 7.3% took two, 56.7% took three, 33.3% took four and 2.7% took five. Only 10% of subjects took a mid-morning meal. Breakfast and merienda (a light evening snack) were the meals most frequently omitted. A positive, significant relationship was found to exist between the number of meals taken per day and the intake of fibre (r = 0.2737), thiamin (r = 0.1671), pyridoxine (r = 0.2060), magnesium (r = 0.2423) and the percentage of energy provided by carbohydrates (r = 0.2144). Women subjects who took 2-3 meals per day showed greater body mass indices and a greater proportion were overweight/obese compared to those who took 4-5 meals per day. Subjects who took 4-5 meals per day showed higher levels of HDL-cholesterol and lower levels of LDL-cholesterol/HDL-cholesterol and cholesterol/HDL-cholesterol than did those who took fewer meals per day. Inverse, significant relationships were also found between the number of meals per day and serum cholesterol (r = 0.2297) and LDL-cholesterol levels (r = 0.1984). Taking into account energy and nutrient intakes, the incidence of obesity/overweight and serum lipid and lipoprotein levels, the consumption of 4-5 meals per day would seem more advisable for the elderly than the taking of fewer meals.

Influence of the number of meals taken per day on cardiovascular risk factors and the energy and nutrient intakes of a group of elderly people.

The aim of this investigation was to analyse the influence of the number of meals per day on a range of cardiovascular risk factors and on the energy and nutrient intakes of a group of elderly people. The participants in this study were 150 elderly people (64 men and 86 women) from Madrid. Food intake was followed over a period of 5 days. "Precise individual weighing" was used to determine the intake of institutionalized subjects (n = 58) whilst "food intake records" were used to register the same for independent subjects (n = 92). The nutrient and energy intake of the studied population was then determined from these data. The number of meals taken was also recorded. Serum cholesterol and triacylglycerol levels were determined using enzymatic methods. In this population, the meal most frequently omitted was breakfast. No subject took only one meal per day, though 7.4% took only two. 56.6% took three meals and 36% took four. No subject took more than four meals per day. As the number of meals taken increased, so too the covering of theoretical energy expenditure, and the intakes of a range of nutrients became closer to those recommended e.g. proteins, fibre, vitamin C, thiamin, riboflavin, calcium, magnesium and iodine. As the number of meals taken per day increased, carbohydrate intake (in g/1000 Kcal and as % of energy) also increased, and approached recommended levels more closely. As observed in other studies, blood cholesterol levels were seen to be negatively correlated with increasing number of meals (r = -0.2297, p < 0.05). Further, those subjects who distributed their food intake more evenly throughout the day showed lower serum cholesterol (p < 0.05). VLDL-cholesterol (p < 0.05) and triacylglycerol levels (p < 0.05). The results favour the distribution of energy intake over the day as a method of improving nutritional status and as a factor that might improve blood lipid profiles.

Dietary intake of a physically active elderly Spanish male group of high socioeconomic status.

The energy and nutrient intake of a group of 29 non-institutionalised elderly males was evaluated. Subjects were between 65 and 79 years of age and practised sport (usually tennis) daily. Their high income classified them as belonging to a high socioeconomic group. The subjects consumed more fruits, fish and non-alcoholic beverages than results reported for the sedentary elderly. Although the nutritional situation of the subjects is better than that of other elderly Spanish groups, more than 50% of the population showed intakes of vitamin D, zinc and magnesium lower than 80% of the recommended intakes (RI). Even though the intake of many of these nutrients will be higher than the observed, given the degree of underreporting noticed, a risk of falling into situations of deficit of these micronutrients must be considered. These require adjustment if a more optimum health and functional status is to be achieved.

Associations between obesity, breakfast-time food habits and intake of energy and nutrients in a group of elderly Madrid residents.

OBJECTIVE: The objective of this study was to gain more knowledge about the breakfast habits of different groups of elderly people and to investigate the differences in breakfast habits between overweight and normal weight elderly subjects. METHODS: A study was made of the food preferences, dietary habits and the intake of energy and nutrients at breakfast in a group of 122 elderly Spanish people (65 men and 57 women) aged 75.7+/-8.7 years. Study participants were divided into two groups: overweight and obese subjects (O) with a body mass index (BMI)>or=25 kg/m2 (58% of the population), and normal weight subjects (NW) with a BMI<25 kg/m2 (42% of the population). The members of each group were further divided into subgroups according to age (>or=80 years of age (Y) and

Differences in breakfast habits between institutionalized and independent elderly Spanish people.

An investigation was made into the breakfast habits of 150 elderly people between 65 and 95 years of age. The food intake of 58 institutionalized subjects was followed by means of "precise individual weighing of food". The food intake of 92 subjects living independently was followed using a prospective method involving the keeping of a "weighed food record". For all subjects the study lasted 5 consecutive days including a Sunday. Institutionalized subjects spent more time at breakfast (p < 0.01 in women) and the food they consumed was more varied, both in terms of number of foods (p < 0.001) and food groups (p < 0.001). Their breakfasts included more fruit (P < 0.001), fibre (P < 0.05 in women) and vitamin A (P < 0.01) than those of independent subjects, 7% of whom took no breakfast at all with a further 8% consuming only a glass of milk or fruit juice. 62.7% of independent and 43.1% of institutionalized subjects consumed an inadequate breakfast (i.e. their breakfasts provided less than 20% of their energy expenditure). The breakfasts of institutionalized subjects contained a greater percentage of their total daily intake of carbohydrates (P < 0.001 in women), fibre (P < 0.01 in women), thiamine (p < 0.05 in women), vitamin B12 (p < 0.05 in women, p < 0.001 in men), vitamin D (p < 0.01 in women) and magnesium (p < 0.05 in women). Given the importance of breakfast in the maintenance of a satisfactory nutritive condition, these results suggest that both qualitative and quantitative improvements of elderly people's breakfasts are required. Residing at an old people's home seems to improve the quality of breakfast consumed, especially for elderly women.

Dietary assessment of a group of elderly Spanish people.

The dietary patterns of 60 elderly from Spain (37 women and 23 men) were examined by analysis of the food, energy and nutrient intake during 5 days. The caloric profile was somewhat unbalanced, since the percentage of total energy intake from proteins and lipids was above the recommended limit whereas the proportion of energy derived from carbohydrates was slightly deficient. The degree of underreporting derived by subtracting predicted total daily energy expenditure from self-reported energy intake obtained from a diet control during 5 days is 120 kcal/day in men and 334 kcal/day in women. More than 50% of the population showed intakes of pyridoxine, folates, vitamin A (only in men), vitamin D, vitamin E. zinc, magnesium and iron (only in women) lower than those recommended. Although it is likely that the real intakes of these micronutrients are higher than the levels measured considering the underreporting, the obtained results show the existence of a risk of deficiency of several nutrients. An increase in the energy intake of the group with a parallel increase in physical activity with a view to avoiding weight gain may be of use in improving the nutritional status of the group. This measure, together with increased consumption of vegetables and milk products especially, may lead to a striking reduction in illness, a finding that is of considerable clinical and public health importance.

[Energy balance and caloric profile in the elderly obese or in those with overweight compared to those of normal weight]. / Balance energético y perfil calórico en ancianos obesos o con sobrepeso en comparación con los de peso normal.

BACKGROUND: Elderly obese people have higher morbidity and mortality rates than those of normal weight and thus deeper knowledge of the problem of obesity is required in order to establish measures for prevention and correction. The aim of this study was to analyze the differences in the energetic ingestion and caloric profile in the diets of elderly patients based on their body mass index (BMI). METHODS: A collective of 127 elderly patients (44 institutionalized and 83 not) from 65 to 89 years of age were studied being grouped as: overweight-obese elderly (BMI > 25 kg/m2) and normal weight elderly patients (BMI < 25 kg/m2). The ingestion of energy and caloric profile of their diets was calculated in both groups by the "precise individual weight" method (in the institutionalized patients) and by the "register of food consumption" (in non institutionalized patients). The data of energetic ingestion were validated by comparison with the energy spent calculated on the basis of weight, age, and the daily activities of each patient. RESULTS: No significant differences were found between the energetic ingestion of overweight and obese elderly persons and those of normal weight, although the former had a more unbalanced caloric profile, with greater protein contribution and lesser carbohydrate contribution to total calories. It was also found that overweight and obese elderly patients underevaluate their energetic ingestion more than those of normal weight. CONCLUSIONS: The main difference observed between overweight-obese elderly patients with respect to those of normal weight was in the composition of their diets more than in the total energetic consumption.

Eating behavior and energy and nutrient intake in overweight/obese and normal-weight Spanish elderly.

Dietary patterns were studied in 122 Spanish elderly people divided into two groups: overweight/obese subjects (O) (BMI > or = 25 kg/m2), and normal-weight subjects (NW) (BMI < 25). O subjects ate less fruit and more meat than NW subjects. No differences were found between NW and O subjects with respect to energy intake, but O elderly obtained more of their energy from proteins and less from carbohydrates. Further, O subjects showed a higher cholesterol intake per MJ than NW subjects. The existence of the dietary imbalances seen in the diet of the O elderly may damage their health.

[Influence of meat consumption in relation to various cardiovascular risk factors in the elderly]. / Influencia del consumo de carne en relación con diversos factores de riesgo cardiovascular en ancianos.

It has been analyzed food intake, energy and nutrients, Quetelet index, blood pressure and lipid profile in 180 elderly people from Madrid (71 institutionalized and 109 free-living), in order to get the relationship between meat intake (< 150 or > or = 150 g/day) and the different risk factors from cardiovascular disease and other foodstuff intake. Those elderly people who eat 150 g/day or more (AC) take more food in general. There is a significant difference for meat and cereals, eggs, fruits, beans, and fish products. They have only a poor intake of dairy products when comparing with those who eat less than 150 g/day (BC). As a result of these differences in food habits, the AC group has a superior intake of energy and most part of other nutrients. Nevertheless, it was only significant the difference for the niacin and for percentage of energy derived from saturated fatty acid. There are no significant differences in blood pressure. AC elderly have more Body Mass Index and show serum lipids more satisfactory than the BC ones. High meat intake is not related to high risk from cardiovascular diseases in our elderly people group. The reason is that this high intake is associated with a better intake of other foods which give them, in general, a better nutritional status (with better intake of vitamins related to lipidic metabolism) which may be observed at biochemical level.

Influence of smoking on folate intake and blood folate concentrations in a group of elderly Spanish men.

OBJECTIVE: To investigate the relationship between smoking habits and folate status in a group of elderly Spanish men. DESIGN: We studied folate intake, serum and erythrocyte folate concentrations, hematological and biochemical data in 72 elderly males (comparing 24 smokers data with 44 nonsmokers ones). RESULTS: Percentage deficiencies for folate intake, serum and erythrocyte levels were higher in smokers. Serum folate levels were significantly higher in nonsmokers. Smokers had higher mean corpuscular volume than did nonsmokers. CONCLUSIONS: Smoking could be harmful to the intake and folate status. For smokers who will not give up the habit, improved dietary intake or a folate supplement is advisable.