First steps of in vitro gastrulation in rabbit vitrified embryos.

BACKGROUND: The in vitro rabbit embryo production and their cryopreservation methodologies such as vitrification generate less viable embryos, and occasionally, with significant differences from those that are not subjected to any treatment. Besides, in vitrified rabbit embryos little information is available about exactly when and where begin to emerge the first differences that finally result in foetal losses comparing with non-vitrified embryos. OBJECTIVE: The aim of this study was to evaluate the vitrification effects on the early in vitro gastrulation events. MATERIALS AND METHODS: After oviductal transfers of vitrified and non-vitrified embryos (control) in rabbit recipients, blastocysts from 144h (6-day-old) were recovered and cultured into TCM199 supplemented with rabbit homologous serum media for 48 hours. Gastrula stage and measures of perimeter and area of blastocyst and gastrula were noted. Moreover, eight independent pools consisting of six embryos each one were generated for each experimental group (control and vitrified) and total RNA was isolated to study the OCT4 gene expression. RESULTS: Of 151 control and 164 vitrified morulae transferred, 69.5 % and 70.1 % developed in vivo to 6-day-old blastocyst respectively. After 24 hour of in vitro culture, 41.8 % of vitrified blastocyst had begun the neurulation (stage 5-) versus 22.8 % of control group. Nevertheless, the vitrified group showed the highest percentage of collapsed blastocyst at 48 hours (26.8 %). Non morphometric differences differences were observed in perimeter and area of blastocyst and gastrula between control and vitrified group at 0 and 24 hours. By contrast, perimeter and gastrula areas were slightly higher for the vitrified group than those for the control group at 48 hours of in vitro culture. CONCLUSION: The study reveal the existence of the first morphological differences in vitrified blastocysts of 7 and 8-day-old, marked by a further development of gastrulation in the vitrified group.

The use of isotonic fluid as maintenance therapy prevents iatrogenic hyponatremia in pediatrics: a randomized, controlled open study.

OBJECTIVES: Hypotonic fluids are widely used in pediatrics. Several articles have reported the risk of iatrogenic hyponatremia secondary to this practice. We primarily intend to determine whether the use of isotonic fluids prevents hyponatremia and, secondly, whether these fluids increase the incidence of adverse events. STUDY DESIGN: One hundred twenty-two pediatric patients hospitalized in intensive care unit requiring maintenance fluid therapy were randomized to receive isotonic fluids (isotonic group, NaCl = 140 mEq/L) or hypotonic fluids (hypotonic group, NaCl <100 mEq/L). Electrolyte blood concentration, glycaemia, and blood pressure were measured at 0, 6, and 24 hrs after the beginning of fluid therapy. Plasma creatinine, urine specific gravity, and urine electrolyte concentration were measured at 6 hrs. Standard intention-to-treat analysis and Bayesian analysis were conducted to assess the probability of hyponatremia and hypernatremia in each group. RESULTS: At the time of admission to hospital, no differences in natremia or the percentage of hyponatremia were found between groups. At 24 hrs, the percentage of hyponatremia in the hypotonic group was 20.6% as opposed to 5.1% in the isotonic group (p = 0.02). No differences in the number of adverse events other than hyponatremia were observed between groups. CONCLUSIONS: The use of hypotonic fluids increases the risk of hyponatremia when compared with isotonic fluids at 24 hrs following infusion (number needed to harm [confidence interval 95%] = 7[4;25]). In our sample, the use of isotonic fluids did not increase the incidence of adverse events compared with hypotonic fluids.

Síndrome de Prader-Willi: diagnóstico diferencial / Prader-Willi syndrome: neonatal diagnosis

El síndrome de Prader-Willi (SPW) es una entidad de escasa incidencia que, sin embargo, supone la causa más frecuente de obesidad de origen genético, cuya alteración se sitúa en el cromosoma 15 (q11-13). Para su diagnóstico es necesario que cumpla una serie de criterios, destacando en el periodo neonatal la hipotonía generalizada con dificultades para la alimentación, junto con una criptorquidia secundaria al hipogonadismo de base. A largo plazo, presenta un mayor riesgo de complicaciones de tipo metabólico, entre otras, que condicionan la calidad de vida de los pacientes, siendo fundamental el diagnóstico precoz con el fin de instaurar un tratamiento multidisciplinario temprano en el que participen endocrinólogos, rehabilitadores y psicólogos. Como conclusiones, extraemos que, ante toda hipotonía neonatal, debe considerarse dentro del diagnóstico diferencialel SPW y que, como en nuestro caso, el diagnóstico precoz permite al paciente beneficiarse de una intervención multidisciplinaria desde el primer momento, con lo que disminuye la incidencia de complicaciones y mejora la calidad de vida

Prader-Willi syndrome (PWS) is a rare entity that is, however, the most frequent cause of genetic obesity, with an alteration located on chromosome 15q11-13. The diagnosis is based on a set of criteria, in particular, generalized hypotonia and feeding difficulties during the neonatal period, accompanied by cryptorchidism secondary to hypogonadism. Over the long term, the patients present a higher risk of metabolic complications, among others, that affect the quality of life. Early diagnosis is essential for the purpose of initiating early multidisciplinary treatment involving endocrinologists, physical therapists and psychologists. We conclude that PWS should be included in the differential diagnosis in any case of neonatal hypotonia, and that, as in our case, early diagnosis permits the patient to benefit from a multidisciplinary intervention from the very start, a circumstance that reduces the incidence of complications and improves quality of life

Controversias en la fluidoterapia de mantenimiento en pediatría / Controversies in maintenance fluid therapy in children

En la actualidad, en pediatría, los fluidos hipotónicosson la base de la fluidoterapia de mantenimiento.En los últimos años se han publicado más de 50casos de desarrollo de complicaciones neurológicas,incluso muerte, en relación con hiponatremiaadquirida durante la hospitalización, en niños querecibían fluidos intravenosos. Las situaciones queprecisan fluidoterapia de mantenimiento suelen asociarsecon la existencia de estímulos no osmóticosde la secreción de hormona antidiurética (ADH),siendo éstos junto con la administración de un excesode agua libre, los principales factores implicadosen el desarrollo de hiponatremia nosocomial. El empleode fluidos isotónicos en la fluidoterapia de mantenimientosería la mejor medida preventiva del desarrollode hiponatremia en niños sometidos a fluidoterapiaintravenosa

The current standard in maintenance parenteralfluids is to administer hypotonic saline. There havebeen several reported cases in the last 10 years relatedto hospital-acquired hyponatremia in childrenreceiving hypotonic parenteral fluids. Parenteralfluids requiring conditions are associated with nonosmoticstimulus for antidiuretic hormone productionand parenteral administration of excessiveamounts of water, as hypotonic saline in these conditions,may lead to the development of hospital-acquiredhyponatremia. The administration of isotonicsaline in maintenance parenteral fluids is the mostimportant measure that can be taken to prevent thedevelopment of hyponatremia in children receivingparenteral fluids

Sequential analyses in coercive mother-child interaction: the predictability hypothesis in abusive versus nonabusive dyads.

OBJECTIVE: A two-fold purpose guided the present study: 1) To test the sequential relationship between the child's aversive behavior and both the predictability and the compliance episodes, as well as the sequential relationship between these two mothering episodes proposed by the new predictability hypothesis (Wahler, Williams, & Cerezo, 1990); 2) to explore whether or not these patterns are specific to these dysfunctional dyads by using a nonabusive comparison group. METHOD: Fifty mother-child dyads, 25 abusive and 25 nonabusive, participated in this study. Lag sequential analyses were carried out on 302 hours of direct observation, 178 hours in the abusive group, and 124 in the nonabusive group. RESULTS: Results of the sequential analyses showed that the predictions derived from the compliance and predictability hypotheses were supported in both groups. The only difference between the groups lies in the new predictability hypothesis, so the two mothering reactions are not sequentially related in the nonabusive group. CONCLUSIONS: This study revealed interesting findings which suggest that these patterns are also found in nonabusive mother-child interactions, but there is a qualitative difference between the groups.

Mother-child interactive patterns in abusive families versus nonabusive families: an observational study.

The interest in aspects relative to the maintenance of aversive family interactions is common among investigators who, from many different fronts, treat child and family issues. If these interactions end in episodes of physical abuse of a child by his/her parents, the need to quickly detect these patterns of family violence in order to prevent and treat them is all the more urgent. The present work falls within this context and focuses on a detailed analysis of behavior in the home of both the abusive mother and the victimized child. In line with recent investigations, the work also centers on the analysis of the actual mother-child interaction by carrying out a focused analysis of the behavior of the dyad given that these behaviors greatly affect each other. The study was conducted with a group of 23 mother-child dyads that presented episodes of physical abuse towards the child, and a control group of 24 dyads that did not present any interactional problems. The dyads were observed at home by a group of trained observers using the SOC III system of direct observation (Standardized Observation Codes IIIrd revision, Cerezo, 1991; Cerezo, Keesler, Dunn, & Wahler, 1986). Three stepwise discriminant function analyses were carried out for the variables relative to the maternal behavior, the child's behavior, and the measurement of the mother-child sequence of interaction. The results indicate that behaviors with a negative valence better classify the subjects into the groups to which they belong, obtaining a better classification when the variables relative to the interaction are used in the analysis. It can be concluded that it is necessary to include this measurement in future analysis due to its great classificatory and predictive value.