All patients who had previous Fontan surgery and who subsequently underwent liver biopsy at our institution between January 1990 and July 2010 were identified. For each biopsy specimen, portal and sinusoidal fibrosis were graded and medical records reviewed. Biopsy specimens from 13 patients were examined; the median time from
Fontan surgery to liver biopsy procedure was 16.9 years (range 6.9-25). At the most recent biopsy procedure, 12 patients (92 %) had evidence of portal fibrosis, including 1 patient with portal-based cirrhosis. Thirteen patients (100 %) had at least some degree of sinusoidal fibrosis, including 1 patient with centrilobular-based cirrhosis. Lower platelet count was associated ACY-738 purchase with greater degree of portal fibrosis by ordinal regression (odds ratio 0.84, P = 0.04), and patients with no or mild portal fibrosis had significantly higher platelet counts compared with those with moderate or severe portal disease
(278 +/- A 78 K vs. 160 +/- A 46 K, P = 0.005). Four patients underwent serial biopsy procedures; portal fibrosis was progressed in 3 patients, and sinusoidal fibrosis was progressed in 3 patients. After Fontan surgery, portal and sinusoidal fibrosis are common at liver biopsy and can progress over time. Lower platelet count may represent a marker of portal-based disease in these patients.”
“The delivery rates of 298 patients having see more preimplantation genetic diagnosis with aneuploidy screening (PGS) were compared with the delivery
rates of 144 PGS patients that cancelled the plan for PGS with embryo transfer on day 2 or day 3. The goal of this study was to compare the impact of embryo de-selection with PGS to embryo selection using sequential embryo scoring (SES) on outcome in poor-prognosis patients. Embryos with good sequential scores were more likely to have a normal PGS result than embryos with poor SES scores click here (34% versus 12%; P < 0.05). Patients proceeding with PGS had an overall delivery rate of 15% per oocyte retrieval. There was a significant difference in delivery rates between patients with less than six embryos and patients with greater than six embryos (6% versus 19%; P < 0.005). The overall delivery rate for patients having transfers without PGS was 23% (P < 0.05 compared with PGS patients) with no difference between low and good responders. It was concluded that PGS neither enhanced nor impaired delivery rates in high responding poor-prognosis patients yet SES may be more accurate than PGS as a means of selection for low-responding poor-prognosis patients. (C) 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry captures information on interstage management of infants with hypoplastic left heart syndrome (HLHS).