RESUMEN

An equilibrium needs to be established by the cellular and acellular components of the ovarian follicle if developmental competence is to be acquired by the oocyte. Both cumulus cells (CCs) and follicular fluid (FF) are critical determinants for oocyte quality. Understanding how CCs and FF influence oocyte quality in the presence of deleterious systemic or pelvic conditions may impact clinical decisions in the course of managing infertility. Given that the functional integrities of FF and CCs are susceptible to concurrent pathological conditions, it is important to understand how pathophysiological factors influence natural fertility and the outcomes of pregnancy arising from the use of assisted reproduction technologies (ARTs). Accordingly, this review discusses the roles of CCs and FF in ensuring oocyte competence and present new insights on pathological conditions that may interfere with oocyte quality by altering the intrafollicular environment.

Asunto(s)

Células del Cúmulo , Líquido Folicular/fisiología , Oocitos/fisiología , Animales , Células del Cúmulo/citología , Células del Cúmulo/fisiología , Diabetes Mellitus/patología , Endometriosis/patología , Femenino , Líquido Folicular/citología , Humanos , Infertilidad Femenina/etiología , Infertilidad Femenina/patología , Obesidad/complicaciones , Obesidad/patología , Oocitos/citología , Infección Pélvica/complicaciones , Infección Pélvica/patología , Síndrome del Ovario Poliquístico , Embarazo

RESUMEN

UNLABELLED: The etiology of endometriosis remains poorly understood but circulating stem cells may contribute. Telomeres shorten with cell divisions and age. Stem cells attempt to compensate for telomere attrition through the action of telomerase. Since circulating stem cells may contribute to endometriosis, we compared telomere content in lymphocytes of patients with and without endometriosis. METHODS: Observational study comparing peripheral lymphocytes telomere content, measured by quantitative polymerase chain reaction, in patients with (n = 86) and without endometriosis (n = 21). FINDINGS: Patients with endometriosis had longer telomeres than that of matched, endometriosis-free controls (telomere to single copy gene ratio [T/S ratio] of 1.62 vs 1.34, respectively, P = .00002). Patients with endometriosis were 8.1-fold more likely to have long telomeres. (odds ratio = 8.1, 95% confidence interval: 1.28-51.57, P = .0264). INTERPRETATION: Longer telomeres could be consistent with a stem cell origin of endometriosis.

Asunto(s)

Endometriosis/genética , Linfocitos/metabolismo , Homeostasis del Telómero , Telómero/genética , Adulto , Estudios de Casos y Controles , Endometriosis/sangre , Endometriosis/diagnóstico , Femenino , Marcadores Genéticos , Humanos , Reacción en Cadena de la Polimerasa , Telómero/metabolismo

RESUMEN

Most patients inadvertently miss an occasional dose of antihypertensive therapy, and hence drugs that provide sustained blood-pressure (BP) reduction beyond the 24-h dosing interval are desirable. The primary objective of this study was to compare the 24-h mean ambulatory BP reductions from baseline after a simulated missed dose of the direct renin inhibitor aliskiren, irbesartan or ramipril. In this double-blind study, 654 hypertensive patients (24-h mean ambulatory diastolic BP (MADBP) >or=85 mm Hg) were randomized 1:1:1 to once-daily aliskiren 150 mg, irbesartan 150 mg or ramipril 5 mg. Doses were doubled after 2 weeks. At day 42, patients were again randomized equally within each group to receive 1 day of placebo ('missed dose') on either day 42 or day 49. Patients with a successful 24-h ambulatory BP measurement at baseline and on day 42/49 were included in the analyses. The 24-h mean ambulatory systolic BP (MASBP)/MADBP reductions from baseline after a missed dose of aliskiren 300 mg (9.3/7.0 mm Hg) were similar to irbesartan 300 mg (9.5/7.3 mm Hg) and significantly larger than ramipril 10 mg (7.1/5.0 mm Hg, P

Asunto(s)

Amidas/administración & dosificación , Bloqueadores del Receptor Tipo 1 de Angiotensina II/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina/administración & dosificación , Antihipertensivos/administración & dosificación , Compuestos de Bifenilo/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Fumaratos/administración & dosificación , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación , Ramipril/administración & dosificación , Tetrazoles/administración & dosificación , Adulto , Anciano , Amidas/efectos adversos , Bloqueadores del Receptor Tipo 1 de Angiotensina II/efectos adversos , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Antihipertensivos/efectos adversos , Compuestos de Bifenilo/efectos adversos , Monitoreo Ambulatorio de la Presión Arterial , Brasil , Canadá , Método Doble Ciego , Esquema de Medicación , Europa (Continente) , Femenino , Fumaratos/efectos adversos , Humanos , Hipertensión/fisiopatología , Irbesartán , Masculino , Persona de Mediana Edad , Ramipril/efectos adversos , Tetrazoles/efectos adversos , Factores de Tiempo , Resultado del Tratamiento