The Medicines and Healthcare products Regulatory Agency (MHRA) today issued a drug alert to the healthcare community advising them of the recall of the human papillomavirus (HPV) vaccination batch quarantined yesterday following the death of a 14-year-old girl.

HIV/AIDS is up to five times more prevalent in American prisons than in the general population. Adherence to treatment programs can be strictly monitored in prison. However, once prisoners are released, medical monitoring becomes problematic. A new study suggests the majority (76 percent) of inmates take their antiretroviral treatment intermittently once they leave prison, representing a higher risk to the general population.

If future warming trends that scientists have projected are realized, one of the country's most aggressive exotic plants will have the potential to invade more US land area, according to a new study. The study found that tamarisk -- prevalent today in some parts of the region, but generally limited to warm and dry environments -- could expand its range into currently uninvaded areas.

As part of an effort to develop effective medical therapies that block the progression of liver cyst growth in patients with autosomal dominant polycystic kidney disease, researchers have found that the liver cyst walls develop and maintain a vasculature as they grow out from the body of the liver and that factors released by epithelial cells that line the liver cyst wall lumen can drive the proliferation and development of vascular endothelial cells.

What The Ninth Annual Controversies and Advances in Treatment of Cardiovascular Disease continuing medical education conference will feature several discussions and presentations on how healthcare reform could affect cardiovascular disease patients' diagnosis, treatment and outcome.

Objective: To investigate whether early and short follicular administration of GnRH antagonist using the flexible protocol has the potential to improve IVF-ET clinical results.Design: Prospective, controlled, randomized study.Setting: University-affiliated assisted reproductive technology unit.Patient(s): Fifty-three consecutive infertile women were enrolled to the study and control groups.Intervention(s): Both groups were treated with recombinant FSH and the flexible GnRH antagonist protocol. Women in the study group were additionally supplemented with three injections of GnRH antagonist (0.25 mg/d on days 1, 2, and 3 of the menstrual cycle).Main Outcome Measure(s): Hormonal milieu, oocyte meiotic status, competence for normal fertilization, cleavage, and clinical pregnancy rate.Result(s): Both groups had comparable baseline characteristics. The duration of recombinant FSH treatment was significantly longer in the study group as compared with the control group (10.9 ± 3.1 and 9.7 ± 1.3 days, respectively). The number of follicles ≥14 mm and E2 level on the day of hCG administration, number of retrieved oocytes, and endometrial thickness were similar between the two groups. However, the fertilization rate was significantly higher in the study as compared with the control group (85% ± 16% and 69% ± 24%, respectively). Moreover, the cumulative rate of mature first polar body oocytes was significantly higher in the study group as compared with the control group (93% and 85%, respectively). Concomitantly, day-3 FSH and LH levels after initiation of treatment were significantly lower in the study as compared with the control group (6.1 ± 2.4 mIU/mL vs. 7.2 ± 1.9 mIU/mL and 2.4 ± 1.6 mIU/mL vs. ...

Objective: To emphasize the importance of complete ultrasonographic evaluation during the first trimester of pregnancy.Design: Case report.Setting: Obstetric unit in a training and research hospital.Patient(s): A 27-year-old primigravida woman who reached 37 weeks' gestation with a noncommunicating rudimentary horn pregnancy.Intervention(s): The accurate diagnosis of a noncommunicating rudimentary horn pregnancy was made after cesarean section at 37 weeks' gestation. Rudimentary horn excision and ipsilateral salpingectomy were performed during exploration.Main Outcome Measure(s): Early diagnosis using sonography to prevent maternal morbidity and mortality.Result(s): A female baby with a 7/10 apgar score was delivered successfully. The patient and her baby were both discharged in good health.Conclusion(s): Rudimentary uterine horn pregnancy should always be considered as a differential diagnosis of intrauterine pregnancy in a bicornuate uterus. A thorough ultrasonographic examination should be performed on the aspects of the pregnancy and the pelvic anatomy. Lack of knowledge of and experience with müllerian anomalies still makes these anomalies difficult to recognize even with laparoscopy.

Objective: To present the effectiveness of intracytoplasmic sperm injection (ICSI) using globozoospermic sperm and assisted oocyte activation by electrical stimulation.Design: A case report.Setting: A private IVF center in Japan.Patient(s): A man with globozoospermia.Intervention(s): Acridine orange (AO) test, mouse oocyte activation test, and ICSI with electrical oocyte activation.Main Outcome Measure(s): Fertilization, pregnancy, and live birth.Result(s): In the first ICSI attempt, neither of the two injected oocytes fertilized. Staining of the patient's sperm with AO showed that only 2.9% of the sperm emitted a green fluorescence at the characteristic round head (sperm with native DNA content). The mouse oocyte activation test using the roundheaded sperm showed that the normal fertilization rate was 78.9% when SrCl2 was used for assisted oocyte activation; however, it was 6.0% without assisted oocyte activation. We confirmed that the sperm had defective ability to activate oocytes. In the second ICSI attempt, human oocytes were activated electrically with use of a single square direct current pulse after microinjection. All the seven injected oocytes fertilized normally, and two eight-cell embryos were transferred on day 3. Clinical pregnancy was confirmed, and a healthy girl weighing 2362 g was delivered at 37 weeks of gestation by cesarean section.Conclusion(s): This is the first successful outcome of ICSI using globozoospermic sperm and electrical oocyte activation. The electroactivation obviates the need for the use of potentially harmful drugs for activation.

We examined in a prospective longitudinal pregnancy cohort the influence of advancing gestation and baseline maternal adiposity on antimüllerian hormone (AMH) and determined whether maternal hormones (insulin, leptin, adiponectin, E2, and sex hormone–binding globulin) correlate with alterations in AMH. We demonstrate that first-trimester AMH is associated negatively with maternal adiposity, that circulating levels decline during the second and third trimesters of pregnancy, and that in univariate and multivariate models adiponectin is associated positively with AMH during this period of pregnancy-related decline.

Objective: To explore the role of long-standing hormone replacement therapy (HRT) in the malignant transformation of endometriosis.Design: Short case series. Three cases of women with pelvic clearance receiving long-standing HRT studied in detail.Setting: Teaching hospital in the United Kingdom (Gynaecological Cancer Centre) (Institutional Review Board approval was not obtained as it was not deemed necessary, this being a case series).Patient(s): Women with a history of pelvic clearance for endometriosis and longstanding HRT.Intervention(s): HRT.Main Outcome Measure(s): Malignant transformation of endometriosis.Result(s): Long-standing HRT in all three women with pelvic clearance for endometriosis resulted in malignant transformation of residual endometriosis many years after the initial surgery. All cases presented with a new pelvic lesion.Conclusion(s): The diagnosis of malignant transformation needs to be considered in women with a history of endometriosis and with long-term HRT use in whom a new pelvic lesion is detected. The risk of malignant transformation in women with endometriosis after pelvic clearance receiving HRT needs to be explored further. Surveillance with CA-125 and imaging in such cases to predict recurrence or malignant transformation needs to be studied further in a research setting.