[Headache in puerperium].

Background: Sheehan's syndrome is a rare complication of excessive postpartum hemorrhage with impaired function of the pituitary gland (hypopituitarism). Clinical presentation includes headache, fatigue, nausea, symptoms due to electrolyte imbalance and pituitary hormone insufficiency. Cranial imaging can support the diagnosis if pituitary gland ischemia or empty sella sign is detected.

Carotenoid dark state to chlorophyll energy transfer in isolated light-harvesting complexes CP24 and CP29.

We present a comparison of the energy transfer between carotenoid dark states and chlorophylls for the minor complexes CP24 and CP29. To elucidate the potential involvement of certain carotenoid-chlorophyll coupling sites in fluorescence quenching of distinct complexes, varying carotenoid compositions and mutants lacking chlorophylls at specific binding sites were examined. Energy transfers between carotenoid dark states and chlorophylls were compared using the coupling parameter, [Formula: see text], which is calculated from the chlorophyll fluorescence observed after preferential carotenoid two-photon excitation.

PsbS-dependent and -independent mechanisms regulate carotenoid-chlorophyll energy coupling in grana thylakoids.

In higher plants, PsbS is known to play a key role in the regulation of photosynthetic light harvesting. However, the molecular mechanism and role of electronic carotenoid-chlorophyll (Chl) interactions for the downregulation of excess excitation (nonphotochemical energy quenching, NPQ) are still poorly understood. Here, we explored carotenoid → Chl energy transfer in isolated grana thylakoid membranes from mutants either deficient in or overexpressing PsbS.

Comparison of the direct antiglobulin test and the eluate technique for diagnosing haemolytic disease of the newborn.

Objective: The direct antiglobulin test (DAT) is an important tool for identification of haemolytic disease of the newborn (HDN) caused by erythrocyte immunization. Although this test has been used for decades, accurate insights into its diagnostic properties and optimal use in the diagnosis of HDN are limited. We aimed to gain more insight into the diagnostic properties of the DAT for HDN by comparing it with erythrocyte eluate screening.

Carotenoid-chlorophyll coupling and fluorescence quenching in aggregated minor PSII proteins CP24 and CP29.

It is known that aggregation of isolated light-harvesting complex II (LHCII) in solution results in high fluorescence quenching, reduced chlorophyll fluorescence lifetime, and increased electronic coupling of carotenoid (Car) S1 and chlorophyll (Chl) Qy states, as determined by two-photon studies. It has been suggested that this behavior of aggregated LHCII mimics aspects of non-photochemical quenching processes of higher plants and algae. However, several studies proposed that the minor photosystem II proteins CP24 and CP29 also play a significant role in regulation of photosynthesis.

Elevated early follicular progesterone levels and in vitro fertilization outcomes: a prospective intervention study and meta-analysis.

Objective: To assess the impact of elevated early follicular progesterone (P) levels in gonadotropin-releasing hormone (GnRH) antagonist cycles on clinical outcome using prospective data in combination with a systematic review and meta-analysis.

Design: Nested study within a multicenter randomized controlled trial and a systematic review and meta-analysis.

Setting: Reproductive medicine center in an university hospital.

Alterations in classical and nonclassical HLA expression in recurrent and progressive HPV-induced usual vulvar intraepithelial neoplasia and implications for immunotherapy.

Immunotherapy of usual vulvar intraepithelial neoplasia (uVIN) is promising; however, many patients still fail to show clinical responses, which could be explained by an immune escape through alterations in human leukocyte antigen (HLA) expression. Therefore, we analyzed a cohort of patients with a primary (n = 43) and subsequent recurrent uVIN lesion (n = 20), vaccine-treated uVIN patients (n = 12), patients with human papillomavirus (HPV)-induced vulvar carcinoma (n = 21) and healthy controls (n = 26) for the expression of classical HLA-class I/II and nonclassical HLA-E/-G and MHC class I chain-related molecule A (MICA). HLA-class I was downregulated in 70% of uVIN patients, including patients with a clinical response to immunotherapy.

Comparison of early versus late initiation of GnRH antagonist co-treatment for controlled ovarian stimulation in IVF: a randomized controlled trial.

Study Question: What is the impact of initiating GnRH antagonist co-treatment for in vitro fertilization (IVF) on cycle day (CD) 2 compared with CD 6 on live birth rate (LBR) per started cycle and on the cumulative live birth rate (CLBR)?

Summary Answer: Early initiation of GnRH antagonist does not appear to improve clinical outcomes of IVF compared with midfollicular initiation.

What Is Known Already: During ovarian stimulation for IVF, GnRH antagonist co-treatment is usually administered from the midfollicular phase onwards. Earlier initiation may improve the follicular phase hormonal milieu and therefore overall clinical outcomes.

The back and forth of energy transfer between carotenoids and chlorophylls and its role in the regulation of light harvesting.

Many aspects in the regulation of photosynthetic light-harvesting of plants are still quite poorly understood. For example, it is still a matter of debate which physical mechanism(s) results in the regulation and dissipation of excess energy in high light. Many researchers agree that electronic interactions between chlorophylls (Chl) and certain states of carotenoids are involved in these mechanisms.

Carotenoid-chlorophyll coupling and fluorescence quenching correlate with protein packing density in grana-thylakoids.

The regulation of light-harvesting in photosynthesis under conditions of varying solar light irradiation is essential for the survival and fitness of plants and algae. It has been proposed that rearrangements of protein distribution in the stacked grana region of thylakoid membranes connected to changes in the electronic pigment-interaction play a key role for this regulation. In particular, carotenoid-chlorophyll interactions seem to be crucial for the down-regulation of photosynthetic light-harvesting.

Carbetocin in comparison with oxytocin in several dosing regimens for the prevention of uterine atony after elective caesarean section in the Netherlands.

Purpose: The aim of the study was to compare the prophylactic effects of carbetocin with those of oxytocin for the prevention of uterine atony in patients undergoing elective caesarean section (CS) in the Netherlands. The primary endpoint was the need for additional uterotonic medication.

Methods: Each of the five participating Dutch hospitals treated 50-100 term patients with 100 μg of intravenous carbetocin on prescription.

No reduction of manual removal after misoprostol for retained placenta: a double-blind, randomized trial.

Objective: To test the effect of 800 μg of misoprostol orally on the prevention of manual removal of retained placenta.

Design: Multicenter, double-blinded, placebo-controlled, randomized trial.

Setting: One university and one non-university teaching hospital in the Netherlands.

Feasibility of nonselective testing for hemoglobinopathies in early pregnancy in The Netherlands.

Objective: To examine the feasibility of standardized hemoglobinopathy (HBP) carrier testing for pregnant women in The Netherlands in addition to the standard anemia screening.

Methods: We assessed the prevalence of HBP in women at the time of the first pregnancy visit using both a prospective cohort (N = 703) and a retrospective series of women selected at random (N = 588). For the purpose of analysis, the population was divided into a high risk and a low risk group for HBP based on maternal ethnicity.

Vaginal misoprostol prior to insertion of an intrauterine device: an RCT.

Background: Misoprostol is an agent that may ripen the cervix in nonpregnant women. Here, we investigate whether vaginal misoprostol administered prior to intrauterine device (IUD) insertion reduces the number of failed insertions, insertion-related complications and pain during insertion.

Methods: We conducted a double-blinded, multicenter randomized controlled trial among patients requesting an IUD.

Measurement and significance of sperm morphology.

The measurement or evaluation and clinical significance of human sperm morphology has always been and still is a controversial aspect of the semen analysis for the determination of a male's fertility potential. In this review the background of the development of the evaluation criteria for sperm morphology will be discussed. Aspects of criticism on the strict criteria definition and use of the criteria for sperm morphology evaluation will be discussed as well as possible reasons for the decline in normal sperm morphology values and how we can compromise for this phenomenon resulting in the very low normal reference value as published in the 2010 WHO manual for the Examination and Processing of Human Semen.

Correlation of Car S(1) → Chl with Chl → Car S(1) energy transfer supports the excitonic model in quenched light harvesting complex II.

Recently, excitonic carotenoid-chlorophyll interactions have been proposed as a simple but effective model for the down-regulation of photosynthesis in plants. The model was proposed on the basis of quenching-correlated electronic carotenoid-chlorophyll interactions (Car S(1) → Chl) determined by Car S(1) two-photon excitation and red-shifted absorption bands. However, if excitonic interactions are indeed responsible for this effect, a simultaneous correlation of quenching with increased energy transfer in the opposite direction, Chl Q(y) → Car S(1), should be observed.

National perinatal audit, a feasible initiative for the Netherlands!? A validation study.

Objective: To explore the feasibility of a national perinatal audit organization.

Design: Validation study.

Setting: Three regions in the Netherlands.

Double-blind evaluation of ritodrine sustained release for oral maintenance of tocolysis after active preterm labour.

Objective: To evaluate the effect of ritodrine sustained release capsules for maintaining uterine quiescence after successful treatment of active preterm labour.

Design: Multicentre placebo-controlled trial.

Setting: Five teaching hospitals in the Netherlands.

Randomised comparison between a loading and incremental dose model for ritodrine administration in preterm labour.

Objective: To compare a new loading dose regimen for intravenous ritodrine administration in preterm labour with the conventional dose regimen.

Design: Multicentre randomised trial using numbered opaque sealed envelopes.

Setting: Five teaching hospitals in the Netherlands.

A loading model for ritodrine administration in preterm labour.

Objective: To develop a ritodrine infusion scheme for preterm labour that avoids plasma levels above those needed for tocolysis, requires only one rate adjustment, and is easy to apply in practice.

Design: Prospective study of tocolytic effect and plasma ritodrine concentrations during application of the infusion scheme.

Setting: High risk labour ward.

A loading-dose infusion scheme for intravenous tocolysis with ritodrine: a pilot study.

A loading-dose infusion scheme for intravenous ritodrine therapy was tested in twelve patients with preterm labour. We started with a rather high (386 micrograms/min) infusion rate, but the moment tocolysis was reached this infusion rate was reduced to a level needed to maintain the plasma concentration then found. Plasma samples of ritodrine were taken the moment tocolysis was reached and in the steady state, and compared with each other and with expected and calculated plasma concentrations.

cis-Diaminechloroplatinum in the treatment of advanced primary squamous cell carcinoma of the vaginal wall: a case report.

A 34-year-old patient with advanced primary squamocellular vaginal carcinoma was treated with external radiation (4000 cGy to the pelvis) and a line source Cesium application delivering 4000 cGy to the vaginal wall. During this treatment the patient developed a lesion on her back that proved to be a metastasis of a squamocellular cancer. The patient was started on six courses of cisplatin as a single agent.