ContextThe prevalence of overweight among children and adolescents increased
between 1988 and 2000 The change in blood pressure among children and adolescents
over that time and the role of overweight is unknownObjectiveTo examine trends in systolic and diastolic blood pressure among children
and adolescents between 1988 and 2000Design, Setting, and PopulationTwo serially conducted cross-sectional studies using nationally representative
samples of children and adolescents, aged 8 to 17 years, from the third National
Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994
(n = 3496) and NHANES 1999-2000 (n = 2086)Main Outcome MeasuresSystolic and diastolic blood pressure levelsResultsIn 1999-2000, the mean (SE) systolic blood pressure was 1060 (03)
mm Hg and diastolic blood pressure was 617 (05) mm Hg After adjustment
for age, mean systolic blood pressure was 16 mm Hg higher among non-Hispanic
black girls (P = 11) and 29 mm Hg higher among
non-Hispanic black boys (P<001) compared with
non-Hispanic whites Among Mexican Americans, girls' systolic blood pressure
was 10 mm Hg higher (P = 21) and boys' was 27
mm Hg higher (P<001) compared with non-Hispanic
whites (P<001) With further adjustment for body
mass index, these differences were attenuated After age, race/ethnicity,
and sex standardization, systolic blood pressure was 14 (95% confidence interval
[CI], 06-22) mm Hg higher (P<001) and diastolic
blood pressure was 33 (95% CI, 21-45) mm Hg higher in 1999-2000 (P<001) compared with 1988-1994 With further adjustment
for differences in the body mass index distribution in 1988-1994 and 1999-2000,
the increase in systolic blood pressure was reduced by 29% and diastolic blood
pressure was reduced by 12%ConclusionsBlood pressure has increased over the past decade among children and
adolescents This increase is partially attributable to an increased prevalence
of overweight

https://jamanetwork.com/journals/jama/articlepdf/198685/joc32581.pdf

Trends in blood pressure among children and adolescents.

Reproduction is required for the survival of all mammalian species, and thousands of essential 'sex' genes are conserved through evolution. Basic research helps to define these genes and the mechanisms responsible for the development, function and regulation of the male and female reproductive systems. However, many infertile couples continue to be labeled with the diagnosis of idiopathic infertility or given descriptive diagnoses that do not provide a cause for their defect. For other individuals with a known etiology, effective cures are lacking, although their infertility is often bypassed with assisted reproductive technologies (ART), some accompanied by safety or ethical concerns. Certainly, progress in the field of reproduction has been realized in the twenty-first century with advances in the understanding of the regulation of fertility, with the production of over 400 mutant mouse models with a reproductive phenotype and with the promise of regenerative gonadal stem cells. Indeed, the past six years have witnessed a virtual explosion in the identification of gene mutations or polymorphisms that cause or are linked to human infertility. Translation of these findings to the clinic remains slow, however, as do new methods to diagnose and treat infertile couples. Additionally, new approaches to contraception remain elusive. Nevertheless, the basic and clinical advances in the understanding of the molecular controls of reproduction are impressive and will ultimately improve patient care.

/pdf/the-biology-of-infertility-research-advances-and-clinical-36ufrj51t1.pdf

The biology of infertility: research advances and clinical challenges

Objective To assess the effect of treatment for cervical intraepithelial neoplasia (CIN) on obstetric outcomes and to correlate this with cone depth and comparison group used. Design Systematic review and meta-analysis. Data sources CENTRAL, Medline, Embase from 1948 to April 2016 were searched for studies assessing obstetric outcomes in women with or without previous local cervical treatment. Data extraction and synthesis Independent reviewers extracted the data and performed quality assessment using the Newcastle-Ottawa criteria. Studies were classified according to method and obstetric endpoint. Pooled risk ratios were calculated with a random effect model and inverse variance. Heterogeneity between studies was assessed with I2 statistics. Main outcome measures Obstetric outcomes comprised preterm birth (including spontaneous and threatened), premature rupture of the membranes, chorioamnionitis, mode of delivery, length of labour, induction of delivery, oxytocin use, haemorrhage, analgesia, cervical cerclage, and cervical stenosis. Neonatal outcomes comprised low birth weight, admission to neonatal intensive care, stillbirth, APGAR scores, and perinatal mortality. Results 71 studies were included (6 338 982 participants: 65 082 treated/6 292 563 untreated). Treatment significantly increased the risk of overall ( Conclusions Women with CIN have a higher baseline risk for prematurity. Excisional and ablative treatment further increases that risk. The frequency and severity of adverse sequelae increases with increasing cone depth and is higher for excision than for ablation.

pdf/adverse-obstetric-outcomes-after-local-treatment-for-3zcqwcabfu.pdf

Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis

15. 14. Ogedengbe OK, Giwa-Osagie OF, Ogunyemi O. Implications of pattern of tubal disease for microsurgery and in-vitro fertilisation in Lagos. Journal of the National Medical Association , 1987, 79:510–512.

/pdf/current-practices-and-controversies-in-assisted-reproduction-wq5pndjqi6.pdf

Current Practices and Controversies in Assisted Reproduction

ContextIt is unclear whether treatments for cervical intraepithelial neoplasia
(CIN) increase the subsequent risk of preterm delivery. Most studies have
lacked sufficient sample size, mixed heterogeneous subtypes of preterm delivery,
and failed to control for confounding factors.ObjectiveTo determine whether cervical laser and loop electrosurgical excision
procedure (LEEP) treatments increase risk of preterm delivery and its subtypes.Design, Setting, and ParticipantsRetrospective cohort study conducted among women evaluated at a colposcopy
clinic serving Auckland, New Zealand (1988-2000), comparing delivery outcomes
of untreated women (n = 426) and those treated (n = 652) with laser conization,
laser ablation, or LEEP. Record linkage using unique health identifiers identified
women who had subsequent deliveries.Main Outcome MeasuresTotal preterm delivery and its subtypes, spontaneous labor and premature
rupture of membranes before 37 weeks' gestation (pPROM).ResultsThe overall rate of preterm delivery was 13.8%. The rate of pPROM was
6.2% and the rate of spontaneous preterm delivery was 3.8%. Analyses showed
no significant increase in risk of total preterm delivery (adjusted relative
risk [aRR], 1.1; 95% confidence interval [CI], 0.8-1.5) or spontaneous preterm
delivery (aRR, 1.3; 95% CI, 0.7-2.6) for any treatment. Risk of pPROM was
significantly increased following treatment with laser conization (aRR, 2.7;
95% CI, 1.3-5.6) or LEEP (aRR, 1.9; 95% CI, 1.0-3.8), but not laser ablation
(aRR, 1.1; 95% CI, 0.5-2.4). Moreover, risk of pPROM and total preterm delivery
increased significantly with increasing height of tissue removed from the
cervix in conization. Women in the highest tertile of cone height (≥1.7
cm) had a greater than 3-fold increase in risk of pPROM compared with untreated
women (aRR, 3.6; 95% CI, 1.8-7.5).ConclusionsLEEP and laser cone treatments were associated with significantly increased
risk of pPROM. Careful consideration should be given to treatment of CIN in
women of reproductive age, especially when treatment might reasonably be delayed
or targeted to high-risk cases.

/pdf/treatment-for-cervical-intraepithelial-neoplasia-and-risk-of-2ucx670l4i.pdf

Treatment for cervical intraepithelial neoplasia and risk of preterm delivery.

Use of GnRH analogues in ovulation induction for in vitro fertilization: benefit of a short administration regimen.

Obstetrical prognosis for carbon dioxide laser conisation of the uterine cervix

Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 36 - N° 4 - p. 403-408

Léiomyome pelvien extra-utérin : diagnostic et prise en charge

Axillary lymph node dissection, which is now mandatory in the conservative breast cancer surgery and classically involves Berg's two lower levels, is burdened with numerous complications. In 1988 and 1989, two technical modifications were introduced and are described here: padding of the axilla as preventive treatment of postoperative lymphocele and, more recently, functional axillary lymphadenectomy (FAL) in which the medial cutaneous nerve of the arm, the two perforating intercostal nerves and above all the lateral thoracic pedicle (external mammary artery and vein) are spared. These two technical innovations, more respectful of anatomy, are aimed at reducing the morbidity of conservative breast cancer at a time when detection enables breast cancers to be treated at an increasingly early stage, which results in a increase of negative axillary dissections. The postoperative period is simplified (no drainage, immediate mobilization), and the hospital stay is reduced to 2 days. Complementary treatments can thus be started early on, without any functional or cosmetic damage while the number of lymph nodes removes remains the same as in the conventional axillary dissection technique. The authors describe the operative procedures and analyse the 100 cases of conservative breast cancer they have treated with padding and FAL. These two technical modifications are now systematically used by them in the management of breast cancers.

[A new approach to the axilla: functional axillary lymphadenectomy and padding].

Utility of zona pellucida drilling in cases of severe semen alterations in man

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