There was an increase in imprinting disorders in children conceived though IVF and ICSI but insufficient evidence for an association between ART and methylation in other imprinted genes. Heterogeneity in the types of fertility treatment, the imprinted regions studied, the tissues used and the methods of measurement, reduce our ability to assess the full effect of ART on DNA methylation and imprinting. More controlled studies, using standardized methodologies, in larger, better clinically defined populations are needed.

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Introduction Severe acute pancreatitis (SAP) is a common diagnosis in emergency general surgery and can be a cause of significant morbidity and mortality. A consequence of SAP is thrombus in the splanchnic veins. These thrombi can potentially lead to bowel ischaemia or hepatic failure. However, another complication of SAP is retroperitoneal bleeding. At this time, it is thus unclear if treating patients with splanchnic vein thrombosis in the context of SAP is associated with any outcome benefit. A systematic review might clarify this question. Methods A two fold search strategy (one broad and one precise) looked at all published literature. The review was registered on PROSPERO (ID: CRD42018102705). Medline, EMBASE, PubMed, Cochrane and Web of Science databases were searched and potentially relevant papers were reviewed independently by two researchers. Any disagreement was reviewed by a third independent researcher. Primary outcome was reestablishment of flow in the thrombosed vein versus bleeding complications Results Of 1462 papers assessed, a total of 16 papers were eligible for inclusion. There were no randomised controlled trials, 2 were case series, 5 retrospective single centre reviews and 9 studies case reports. There were a total of 198 patients in these studies of whom 92 (46.6%) received anticoagulation therapy. The rates of recanalization of veins in the treated and non-treated groups was 14% and 11% and bleeding complications were 16% and 5%; respectively. However, the included studies were too heterogeneous to undertake a meta-analysis. Conclusion The systematic review highlights the lack evidence addressing this clinical question. Therefore a randomised controlled trial would be appropriate to undertake.

Background:Total hip arthroplasty (THA) is now an increasingly common procedure for people sustaining acetabular fractures. The incidence of acetabular fractures among the elderly population is increasing, and contemporary treatment aims to avoid the risks of prolonged incumbency associated with poor bone stock for fixation or inability to comply with limited weightbearing in this patient group. The concept of acute hip arthroplasty as a treatment for acetabular fracture is, therefore, becoming more topical and relevant. Our systematic review investigates whether THAs for acetabular fractures should be performed acutely, with a short delay, or as a late procedure for posttraumatic osteoarthritis (PTOA) if it develops.Materials and Methods:Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed when undertaking this systematic review. Detailed searches were performed on three different databases, using keywords, such as “acetabular fracture,” “acetabular trauma,” “total hip arthroplasty,” “hip arthroplasty,” and “hip prosthesis.” Studies from 1975 to September 2016 were included in the study. All studies included in the review were independently critically appraised by two of the authors.Results:Forty three studies were included in this review. Only two of them actually compared acute and delayed THAs for acetabular fractures with the rest focusing on one or the other. Results were comparable between acute and late THAs in terms of aseptic loosening, operative time, blood loss, Harris Hip Score, and ability to mobilize postoperatively without aid. Complication rates, however, were much higher in the acute group.Conclusion:Evidence based on this topic is scarce and therefore we have to be cautious about drawing a definitive conclusion. The findings of this systematic review do suggest, however, that acute THAs should be considered in elderly patients, where fixation is not possible, or when their health and ability to rehabilitate are poor. It should also be considered in patients where PTOA is very likely, or where there is already some preexisting degenerative osteoarthritis.

Intracavernous injections of vasoactive drugs, such as alprostadil, are widely used as an effective treatment method for erectile dysfunction. Intracavernous breakage of the needle is a very rare complication of self-injections, with only a few case reports available in the current literature. Treatment methods described vary in the literature, ranging from immediate surgical exploration under ultrasound guidance to non-operative management with delayed needle removal once it is easily palpable. We report a case of an 82-year-old man with a retained intracavernous 1 cm 30 gauge needle tip after injection of alprostadil (Caverject; marketing authorisation number PL 00057/0942) and the innovative use of intraoperative X-ray imaging (fluoroscopy) for removal of this. Level of evidence: level 5 (case report/technique)

History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly more conservational breast cancer surgery. And while mastectomy is no longer a first-line choice for all breast cancers, it is still an important and, really, an essential procedure to discuss and research about. Different types and techniques exist and evidence regarding each is vast-with novel techniques appearing even nowadays. For example, robotic surgery is increasingly more common in many surgical specialties and procedures, and mastectomy is no exception. With several high-profile celebrities recently discussing their experiences of breast cancer and mastectomies, this article covers a multitude of essential aspects relevant to this topic, in turn, hopefully, helping patients and doctors deal with the diagnosis and plan the treatment accordingly. Current breast cancer care and mastectomy trends are also discussed here, giving the readers an up-to-date overview of how breast cancer can and should be managed.

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Epigenetic modulation of the IGF2/H19 imprinted domain in human embryonic and extra-embryonic compartments and its possible role in fetal growth restriction. Epigenetics 2010;5:313-324.