Polycystic ovary syndrome as a plausible evolutionary outcome of metabolic adaptation

As a common endocrinopathy of reproductive-aged women, polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo-anovulation and polycystic ovarian morphology. It is linked with insulin resistance through preferential abdominal fat accumulation that is worsened by obesity. Over the past two millennia, menstrual irregularity, male-type habitus and sub-infertility have been described in women and confirm that these clinical features of PCOS were common in antiquity. Recent findings in normal-weight hyperandrogenic PCOS women show that exaggerated lipid accumulation by subcutaneous (SC) abdominal stem cells during development to adipocytes in vitro occurs in combination with reduced insulin sensitivity and preferential accumulation of highly-lipolytic intra-abdominal fat in vivo. This PCOS phenotype may be an evolutionary metabolic adaptation to balance energy storage with glucose availability and fatty acid oxidation for optimal energy use during reproduction. This review integrates fundamental endocrine-metabolic changes in healthy, normal-weight PCOS women with similar PCOS-like traits present in animal models in which tissue differentiation is completed during fetal life as in humans to support the evolutionary concept that PCOS has common ancestral and developmental origins.

Prenatal and Early Postnatal Exposure to A Natural Disaster and Attention-Deficit/Hyperactivity Disorder Symptoms in Indian Children

The aim of this study was to assess the relation between early exposure to stressful event and a level of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in children, based on outcomes from a natural experiment. It was hypothesized that children pre- and postnatally exposed to cyclone Aila have a higher level of ADHD symptoms compared to the controls, and the effect depends on timing of exposure. Indian children (8-11y) prenatally (N=336) and early postnatally (N=216) exposed to Aila were compared to non-exposed control group of their peers (N=285). ADHD symptoms were assessed using the Conner’s Teacher Rating Scale Revised. The main effect of exposure to the cyclone on total ADHD symptoms’ score, ADHD index, Hyperactivity and Oppositional symptoms was significant and independent of covariates. Both prenatally and postnatally exposed girls, and only postnatally exposed boys, showed significantly higher level of Oppositional symptoms compared to the controls. Cognitive problems/Inattention symptoms were increased in both prenatally and postnatally exposed boys, but not girls, compared to non-exposed children. The timing of programming the later behavior characteristics by stressful experiences due to natural disaster is not limited to fetal life but extends at least into infancy. Sex is a significant modulator of the early stress-ADHD symptoms association.

Deciphering the mutation spectrum in south Indian children with congenital anomalies of the kidney and urinary tract

Background Congenital anomalies of the kidney and urinary tract (CAKUT) cover a spectrum of structural malformations that result from aberrant morphogenesis of kidney and urinary tract. It is the most prevalent cause of kidney failure in children. Hence, it is important from a clinical perspective to unravel the molecular etiology of kidney and urinary tract malformations. Causal variants in genes that direct various stages of development of kidney and urinary tract in fetal life have been identified in 5–20% of CAKUT patients from Western countries. Recent advances in next generation sequencing technology and decreasing cost offer the opportunity to characterize the genetic profile of CAKUT in Indian population and facilitate integration of genetic diagnostics in care of children with CAKUT. Methods Customized targeted panel sequencing was performed to identify pathogenic variants in 31 genes known to cause human CAKUT in 69 south Indian children with CAKUT. The NGS data was filtered using standardized pipeline and the variants were classified using ACMG criteria. Genotype and phenotype correlations were performed. Results The cohort consisted of children mostly with posterior urethral valve (PUV) (39.1%), vesico-ureteric reflux (VUR) (33.3%) and multi-cystic dysplastic kidney (MCDK) (7.2%). No pathogenic or likely pathogenic variants were identified in the study. Most of our variants (n = 39, 60%) were variants of unknown significance with 25.6% (10/39) of them were identified as potentially damaging but were novel variants. Conclusions The present study did not identify any disease-causing monogenic variants in the cohort. The absence of genetic cause may be due to limitations of panel-based testing and also due to higher proportion of children with abnormalities in lower urinary tract than hypodysplasia of kidneys. Clinical, larger targeted panel or whole exome sequencing may be a better method to characterize the genetic profile of Indians patients with CAKUT.

Associations of Longitudinal Fetal Growth Patterns With Cardiometabolic Factors at Birth

BackgroundBirth weight is associated with cardiometabolic factors at birth. However, it is unclear when these associations occur in fetal life. We aimed to investigate the associations between fetal growth in different gestational periods and cord blood cardiometabolic factors.MethodsWe included 1,458 newborns from the Born in Guangzhou Cohort Study, China. Z-scores of fetal size parameters [weight, abdominal circumference (AC), and femur length (FL)] at 22 weeks and growth at 22–27, 28–36, and ≥37 weeks were calculated from multilevel linear spline models. Multiple linear regression was used to examine the associations between fetal growth variables and z-scores of cord blood cardiometabolic factors.ResultsFetal weight at each period was positively associated with insulin levels, with stronger association at 28–36 weeks (β, 0.31; 95% CI, 0.23 to 0.39) and ≥37 weeks (β, 0.15; 95% CI, 0.10 to 0.20) compared with earlier gestational periods. Fetal weight at 28–36 (β, −0.32; 95% CI, −0.39 to −0.24) and ≥37 weeks (β, −0.26; 95% CI, −0.31 to −0.21) was negatively associated with triglyceride levels, whereas weight at 28–36 weeks was positively associated with HDL levels (β, 0.12; 95% CI, 0.04 to 0.20). Similar results were observed for AC. Fetal FL at 22 and 22–27 weeks was associated with increased levels of insulin, glucose, and HDL.ConclusionsFetal growth at different gestational periods was associated with cardiometabolic factors at birth, suggesting that an interplay between fetal growth and cardiometabolic factors might exist early in pregnancy.

Morphometric Study of Cadaveric Spleen in Vidarbha Region

Background: Spleen is one of the largest lymphoid organs that are involved in haemopoitic function also during fetal life. Its anatomy is useful not only for Anatomist but also for Surgeons, Radiologists and Physicians. A lot of variations are observed in the spleen from its shape to size which is important to diagnose or treat the number of diseases. Methodology: This study was carried out on 60 spleens in the dissection hall of our medical college which were removed during routine undergraduate dissection. The parameters studies were shape of the spleen, number of notches (single or multiple), location of notches (Superior or inferior border), weight, breadth, width or length. Results: The 90% spleens has single notch. The weight of the spleens ranges from 89 gm to 220 gm with an average 142.6 gm. Range of breadth observed 3.5cm to7.4cm with an average 5.8cm, Range of width observed 2.8cm to 5.7cm with an average 4.1cm. Range of length observed 8.1cm to13.2cm with an average 11.7cm. Conclusion: Morphological variation is very common in spleen and varies according to the genetic, geographic, nutrition and work habits of individual and varies regions to regions of India. Morphological analysis is under reported and need to be carry out at different regions and places for obtaining more accurate data.

Folliculogenesis, Fertility and Biotechnology in Dairy Cattle

The ovarian follicle population is formed by thousands of follicles, preantral and antral, where oocytes are included. During fetal life, the first follicles produced are preantral, and, as they undergo the development process, they reach the final stage of antral follicles, where a cavity/or antrum is developed. All this growth phase is called folliculogenesis, and this chapter will abord the most important aspects of this process. Moreover, not all follicles reach the preovulatory phase and can be fertilized, so we will discuss how reproductive biotechniques can positively influence the fertility of bovine females. We will also discuss the possibility of antral follicle count to influence reproductive performance and the correlation to biotechniques. Finally, we present alternatives on how to improve fertility and productive efficiency in dairy herds.

A Scoping Review of Perinatal Palliative Care: Allowing Parents to Be Parents

Objective–Perinatal palliative care (PPC) is an option for patients who discover that their infant has a life-limiting fetal condition, which decreases the burden of the condition using a multidisciplinary approach. Study Design–This review discusses the landmark literature in the past two decades, which have seen significant growth and development in the concept of PPC. Results–The literature describes the background, quality, and benefits of offering PPC, as well as the ethical principles that support its being offered in every discussion of fetal life-limiting diagnoses. Conclusions–PPC shares a similar risk profile to other options after life-limiting diagnosis, including satisfaction with choice of continuation of pregnancy. The present clinical opinion closes by noting common barriers to establishing PPC programs and offers a response to overcome each one. Key Points

The incidence of uterine abnormalities

Background: Congenital uterine abnormalities result from abnormal formation, fusion or resorption of the Mullerian ducts during fetal life. These abnormalities have been associated with an increased rate of miscarriage, preterm birth, and other fetal adverse outcomes. Material and methods: Was performed a clinical observational retrospective study of uterine malformations, diagnosed in the Republic of Moldova. Pelvic MRI (1.5-3 tesla) with contrast and without were examined, from 01.01.2016 to 20.11.2016. During this time, 190 MRIs were performed according to the program, 167 MRIs were included in the study, 23 MRIs were excluded, having total or partial hysterectomy performed. The age of the examined persons is between 81 years and 6 months. Results: 15 uterine malformations were detected, which represent 11.13%. Among the uterine abnormalities were detected 6 cases of bicorn uterus, 3 cases of didelph uterus, 2 cases of uterine agenesis and septate uterus and one case of arcuate uterus, and unicorn. Conclusions: In this study it was determined that the prevalence of uterine malformations in an unselected population in the Republic of Moldova is 11.13%, and that of the septate uterus is 1.2%, data that are similar and correspond to the international literature.

In Vivo Quasi-Elastic Light Scattering Eye Scanner Detects Molecular Aging in Humans and Mice

The absence of clinical tools to evaluate individual variation in the pace of aging represents a major impediment to understanding aging and maximizing health throughout life. The lens is an ideal tissue for quantitative assessment of molecular aging in vivo. Long-lived proteins in lens fiber cells are expressed during fetal life, do not undergo turnover, accumulate molecular alterations throughout life, and are optically accessible in vivo. We used quasi-elastic light scattering (QLS) to measure age-dependent signals in lenses of both healthy human subjects and wild-type C57BL/6 mice. Age-dependent QLS signal changes detected in vivo in humans and mice recapitulated time-dependent changes in hydrodynamic radius, protein polydispersity, and supramolecular order of human lens proteins during long-term incubation (~1 year) and in response to sustained oxidation (~2.5 months) in vitro. Our findings demonstrate that QLS analysis of lens proteins provides a practical technique for noninvasive assessment of molecular aging in vivo.