Evidence Challenges Effectiveness Of Embryo Screening For Older Women
There is growing evidence that a procedure for identifying chromosomal abnormalities in embryos prior to in vitro fertilization is ineffective at helping older women become pregnant, the Wall Street Journal reports. The procedure -- known as pre-implantation genetic screening, or PGS -- is performed in dozen of U.S. fertility clinics and sometimes marketed to older women as a way to increase the odds of a healthy live birth. PGS involves extracting a single cell from a six-cell embryo and inspecting it for chromosomal abnormalities known as aneuploidies; unaffected embryos can then be implanted through IVF. Women older than age 35 have a higher risk of aneuploidies, in which embryos have fewer or more than the usual number of 23 pairs of chromosomes. Aneuploidies can trigger early miscarriage or certain genetics conditions, such as Down syndrome. Most medical experts agree that embryo screening is capable of significantly reducing the risk of Down syndrome and other serious chromosome-related illnesses. However, evidence from several studies increasingly suggests that the procedure does not increase older women"s chances of healthy live births. The American Society for Reproductive Medicine released an initial opinion about PGS in 2007, saying that available evidence does not support the use of embryo screening to increase live birth rates in older women. Andrew La Barbera, scientific director of the society, said, "Since that time, there have been several more trials that have reached the same conclusion." Another shortcoming is that most clinics can only test for fewer than half of the 23 chromosomes, meaning that many defects can go undetected. However, medical experts say that the use of PGS has increased in the two years since ASRM issued its recommendations. According to the Journal, PGS can add more than $2,000 to the roughly $10,000 cost of one IVF cycle. Very few health insurers cover PGS, though some pay for IVF. Some experts contend that studies showing a lack of clinical benefit from PGS do not use more efficient biopsy techniques that can prevent damage to the embryo. Santiago Munne, scientific director for Reprogenetics, said that the treatment is "effective." In a 2007 study, Munne and colleagues used PGS to reduce the rate at which patients miscarried. However, the chances of a woman getting pregnant largely were unchanged, which the authors said could be attributed to the small number of study participants (Naik, Wall Street Journal, 6/1).
Mental Health
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What Is Lyme Disease? What Are Symptoms Of Lyme Disease?
Lyme disease was coined Lyme because it was first reported in three Connecticut towns, including Lyme and Old Lyme, in 1975. It was originally thought to be juvenile rheumatoid arthritis in these three towns. A study carried out by scientists from the Yale School of Public Health, USA and the University of Bath, England, revealed that "Lyme Disease In The U.S. Originated In Europe". According to Medilexicon"s medical dictionary, Lyme Disease is "A subacute inflammatory disorder caused by infection with Borrelia burgdorferi, a nonpyogenic spirochete transmitted by Ixodes scapularis, the deer tick, in the eastern U.S. and I. pacificus, the western black-legged tick, in the western U.Sò€¦" (View the full lyme disease definition). Lyme Disease is also known as borreliosis. It is an emerging infectious disease which is caused by three or more species of bacteria which belong to the Borrelia genus: *Borrelia burgdorferi - the main cause of Lyme disease in the USA *Borrelia afzelii and Borrelia garinii - the main causes of Lyme disease in Europe. How do you get Lyme disease? The Borrelia bacteria is transmitted to animals and humans through the bite of infected ticks. These ticks belong to certain species of the genus Ixodes (hard bodied, hard ticks). The Ixodes dammini tick is the cause of most Lyme disease cases in the northeastern USA. This tick can be found in grassy areas - this includes lawns - , as well as in shrubs and woodland. Experts say they may exist even in a warm winter"s day. The ticks favor moist areas, and have three life stages: larva, nymph and adult. During each stage they take a single meal of blood. The blood may come from humans, dogs, cattle, horses, or any warm-blooded animal. When the tick bites you, you are generally unaware as it is painless. Even though a blood meal is taken at each growth stage, most cases of human and animal Lyme disease happen when the nymph is feeding. The nymph is about the size of a poppy seed and favors small mammals, such as mice. In northeastern USA the white-footed mouse is the main pool of the Lyme disease bacteria. The adult tick favors the white-tailed deer in the USA. The life cycle of the tick takes about 2 years to complete, and involves three separate hosts (animals as s of blood to feed on). Birds may be bitten by larva and nymphs. Experts say birds may be the primary means by which ticks spread out of an area. What are the symptoms of Lyme disease? Experts say infected people in Europe are more likely to have no symptoms, compared to infected people in North America. Symptoms of Early Localized Disease (First Stage) *Headache *Stiff neck *Fever *Muscle aches *Tiredness (fatigue) *Rash - In about half of all Lyme disease cases, the patient has a rash or lesion, called arythema migrans. It starts to become noticeable from a few days to a few weeks after the patient was bitten by an infected tick. What looks like an expanded red ring forms on the patient"s skin - it can also be described as a small, reddish lump about half-an-inch wide, slightly raised or flat. This ring can vary in color - it can be reddish and blotchy, or red throughout. It soon expands outwards, frequently leaving a clearing in the center of normal flesh color. Its eventual size can vary from about an inch or so to the whole area of the patient"s back. The darker the person"s skin is, the more like a bruise it may look. Symptoms of Disseminated Lyme Disease (Second Stage) If the rash is not at the site bite it may be Disseminated Lyme Disease. Disseminated Lyme Disease is the second stage of the disease when it has spread and is and is affecting some body functions. A study carried out by scientists at New York Medical College, Valhalla found that a second rash most likely indicates two tick bites. This second stage of the disease can occur weeks or months after being bitten by an infected tick. The symptoms can include: *A rash that is not where the insect bite is. *Pain in arms and legs *Numbness in arms and legs *Some facial muscles become paralyzed, especially just one side of the face *Fever, bad headaches, stiff neck (indication of Meningitis) *The patient experiences an abnormal heart beat (uncommon) Chronic Lyme disease (third stage) This stage can happen over a wide time range - weeks, perhaps months or even years after the patient was initially infected. It most commonly affects people who never received antibiotic treatment, or patients whose antibiotic treatment did not kill off all the Lyme disease causing bacteria. Symptoms for third stage Lyme disease include: *Chronic arthritis - at least one joint will be painful and swollen for brief periods - most commonly the knees. *Memory loss *Difficulty concentrating (studies are looking into this) *Various nervous system difficulties *Painful muscles - this is usually chronic (long term) *Disturbed and unsettled sleep Lyme disease during pregnancy According to the Centers for Disease Control and Prevention, if a pregnant woman is infected there is no risk for the fetus if the mother receives the right antibiotic treatment. Treatment for expectant mothers is generally similar to that for other infected patients - however, the doctor must select the antibiotic carefully as some are not suitable. It is crucial that a pregnant woman gets her antibiotic after consulting with a qualified physician. What is the treatment for Lyme disease? Scientists at the Centers for Disease Control and Prevention in Fort Collins, Colorado, USA, have developed an injection that protects against two severe diseases transmitted by tick bites: Lyme disease and Anaplasmosis. (Click here to read about it) According to the National Institutes of Health (NIH), Lyme disease can be cured with a few weeks of oral antibiotics. (Related article: " When Are Antibiotics For Lyme Disease Medically Necessary ?"). The following oral antibiotics are commonly used: *Doxycycline *Amoxicillin *Cefuroxime axetil *Ceftriaxone or Penicillin, for those with neurological or cardiac forms of illness who need intravenous injection. People who receive antibiotics during the early stages of infection generally recover completely and quickly. Some patients, however, especially those diagnosed with later stages of Lyme disease, might have persistent or recurrent symptoms. Experts at the NIH say that these patients might benefit from a second 4-week course of antibiotic therapy - they add that longer courses of antibiotic treatment are not good for them for various reasons, among which are serious complications, and even death. Some studies reveal that antibiotic resistance while treating Lyme disease is becoming a problem. Another study indicates that as deer carry many other crippling bacteria, doctors should ask themselves the question "What if it is not Lyme disease?" How to protect yourself from tick bits If you are in an area known for ticks that may carry the bacteria for Lyme disease *Avoid wooded and bushy areas with high grass *Avoid wooded and bushy areas with a lot of leaf litter *Be extra careful in May, June and July *If you find yourself in a tick area, walk down the center of the path, as far away as possible from brush, leaf litter and overgrown grass *Check with local authorities about tick infested areas to avoid Keeping ticks off your skin *Apply tick repellent, ideally repellent with 20% to 30% DEET. Apply on exposed skin and clothing. *Permethrin is also a good repellent. It is commonly purchased at outdoor equipment stores (camping and hunting shops). Apply once to pants, socks, and shoes - the repellent ingredient remains active for several washings. Permethrin kills ticks on contact. *Wear long pants, long sleeves, and long socks. *If your clothing is light colored you are more likely to spot them. *Tuck your pants into your socks or boots *Tuck your shirt into your pants *If you are outdoors in a tick infested area for a long time tape your pants and socks so that ticks can"t crawl under your clothing. Regularly check your skin and clothes for ticks *Before going indoors remove all ticks form your clothes. *Wash clothes in hot water and dry them in high heat for at least 1 hour if in order to kill ticks that you have missed. *Check for ticks before going out, even if you are going out to your own yard . Do not forget to check your armpits, scalp and groin. Remove them immediately using a fine-tipped pair of tweezers. *If a tick is attached to your skin your risk of developing Lyme disease is still very small if you remove it. *However, watch your health closely for 24 hours and be alert for any signs and symptoms of Lyme disease. Controlling ticks around your home Acaricides are pesticides designed to destroy ticks, they can be extremely effective in lowering tick populations. If you get the timing right and apply once towards the end of May or beginning of June, you can reduce tick populations by 60% to 100%. You should check with local authorities about the best timing for acaricide application in your area - be conscious of rules and regulations regarding pesticide application on residential properties. Turn your area into a tick-safe zone Proper landscaping can significantly reduce the tick populations of homes, parks and recreational areas. Remember that ticks love humid wooded areas, and die rapidly in dry and sunny environments. The following tips from the CDC may help: *Clear all leaf litter, tall grasses, and brush around your home and the edges of your lawn. *Wood chips restrict tick migration. Place them between your lawns and wooded areas. *Mow your lawn regularly. Clear brush and leaf litter often. *If you have a bird feeder, keep the area below it clean. *Make sure wood is neatly stacked in dry areas *Place playground equipment, patios and decks away from yard edges and trees. *Controlling the movement of deer populations are important in controlling tick spread. HowPages: [1] 2