Heme oxygenase-1 modulates fetal growth in the rat.

Intrauterine growth restriction is associated with increased perinatal morbidity and mortality as well as with lifelong cardiovascular and metabolic complications. Deficiency of heme oxygenase 1 (HO-1) is associated with growth restriction in mice and in humans, suggesting a role for HO-1 in fetal growth and maintenance of pregnancy. We hypothesized that modulation of HO-1 in the pregnant rat would alter fetal growth.

Prevalence of genetic markers for thrombophilia in recurrent pregnancy loss.

Background: The genetic predispositions to venous thrombosis such as factor V Leiden (FVL) mutation (Arg 506 Gln), prothrombin (FII) gene mutation (G20210A), and mutation of the methylenetetrahydrofolate reductase (MTHFR) gene (C677T) have been reported to be associated with recurrent pregnancy loss. This paper examines the prevalence of markers for genetic thrombophilias in women with recurrent miscarriage.

Methods: The prevalence of FVL, FII G20210A and MTHFR C677T was compared in 108 women with three or more pregnancy losses either exclusively in the first trimester, or mixed first and second trimester losses, with the prevalence found in 82 fertile parous control women without miscarriages.

Effect of raloxifene on the ovarian circulation in women after menopause.

Objective: We sought to determine whether raloxifene effects the ovarian circulation in women after menopause.

Study Design: The resistance indices of the ovarian blood flow were assessed in 130 women after menopause who were randomly assigned to receive either 60 mg of raloxifene, a continuous combined estrogen-progestin tablet daily, or neither treatment for 24 months.

Results: The women who received raloxifene or hormonal replacement therapy had a significant time-related decrease in the resistance index of the ovarian artery blood flow compared to baseline values (resistance index, 0.

Serving underserved and hard-core smokers in a dental school setting.

The dental profession has recognized tobacco cessation as an important part of comprehensive dental care, yet implementation of the Public Health Service clinical practice guideline on "Treating Tobacco Use and Dependence" remains a challenge. This is especially the case for patients presenting in dental clinics for whom smoking represents a large financial burden. Many of these smoking-addicted patients also present with multiple risk factors: dental, medical, and psychiatric.

Use of mifepristone as an example of conflicting and misleading medical information on the internet.

Objective: To evaluate the accuracy and reliability of medical information available on the internet regarding medical abortion using mifepristone, with special emphasis on the possible bias of the internet websites providing the information.

Methods: A systematic search of the internet identified patient-oriented websites distributing medical information about mifepristone. The sites were divided into three groups according to their views of the drug (i.

Management and outcome of pregnancy in women with thrombophylic disorders and past cerebrovascular events.

Objective: To evaluate the maternal and fetal outcome in a cohort of women undergoing a subsequent pregnancy after a previous cerebrovascular event in the presence of thrombophilia.

Patients: Fifteen pregnancies were followed up in 12 women with past cerebrovascular events and thrombophilic disorders. The cerebrovascular events occurred during a previous pregnancy in five patients.

The role of sonographic assessment of cervical length in the prediction of preterm birth in primigravidae with twin gestation conceived after infertility treatment.

Objective: To identify the risk factors for preterm birth in primigravidae with twin gestation and the role of transvaginal ultrasonographic assessment of the cervix.

Methods: Between January 1996 and December 1996, 54 twin pregnancies were prospectively enrolled. All women were at their first pregnancy.

Management by constraints: considering patient volume when adding medical staff to the emergency department.

Background: The emergency department is one of the hospital's busiest facilities and is frequently described as a bottleneck. Management by constraint is a managerial methodology that helps to focus on the most critical issues by identifying such bottlenecks. Based on this theory, the benefit of adding medical staff may depend on whether or not physician availability is the bottleneck in the system.

The development of the fetal vermis: an in-utero sonographic evaluation.

Objective: To establish a nomogram for fetal vermis measurements during gestation.

Methods: A prospective cross-sectional study of normal singleton pregnancies. Measurements of the fetal vermis width (in the axial plane) and height (in the sagittal plane) were performed by high-resolution transabdominal ultrasonography between 18 and 38 weeks of gestation in 256 fetuses.

Increased prevalence of thrombophilia among women with severe ovarian hyperstimulation syndrome.

Objective: To determine the prevalence of markers of thrombophilia in women hospitalized for severe OHSS.

Design: Prospective study.

Setting: Academic research center.

Prediction of hyperbilirubinemia in near-term and term infants.

Objective: The purpose of this study was to determine whether end-tidal carbon monoxide (CO) corrected for ambient CO (ETCOc), as a single measurement or in combination with serum total bilirubin (STB) measurements, can predict the development of hyperbilirubinemia during the first 7 days of life.

Methods: From nine multinational clinical sites, 1370 neonates completed this cohort study from February 20, 1998 through February 22, 1999. Measurements of both ETCOc and STB were performed at 30+/-6 hours of life; STB also was measured at 96+/-12 hours and subsequently following a flow diagram based on a table of hours of age-specific STB.

Subnanometer three-dimensional atom-probe investigation of segregation at MgO/Cu ceramic/metal heterophase interfaces.

Three-dimensional atom-probe (3DAP) microscopy has been applied to the study of segregation at ceramic/metal (C/M) interfaces. In this article, results on the MgO/Cu(X) (where X = Ag or Sb) systems are summarized. Nanometer-size MgO precipitates with atomically clean and atomically sharp interfaces were prepared in these systems by internal oxidation.

Nanometer-scale solute segregation at heterophase interfaces and microstructural evolution of molybdenum nitride precipitates.

The interrelationship between coherency and solute segregation at metal/metal-nitride heterophase interfaces is studied on a subnanometer scale by both atom-probe field-ion and electron microscopies for molybdenum nitride precipitates in Fe-2 at% Mo-X, where X = 0.4 at% Sb or 0.5 at% Sn.

In vitro fertilization following natural cycles in poor responders.

This prospective study was designed to examine the feasibility of natural cycle in vitro fertilization (IVF) in poor responders, and the clinical factors that may predict successful outcome. Twenty-two poor responders underwent IVF treatment with 44 unstimulated cycles. The results of the natural cycles were compared with those of the 55 low-response stimulated cycles of these patients during the 12 months prior to the study.

The role of laparoscopic-assisted myomectomy (LAM).

Laparoscopic myomectomy has recently gained wide acceptance. However, this procedure remains technically highly demanding and concerns have been raised regarding the prolonged time of anesthesia, increased blood loss, and possibly a higher risk of postoperative adhesion formation. Laparoscopic-assisted myomectomy (LAM) is advocated as a technique that may lessen these concerns regarding laparoscopic myomectomy while retaining the benefits of laparoscopic surgery, namely, short hospital stay, lower costs, and rapid recovery.

Comparison of cervical vacuum cup cannula with metal cannula for hysterosalpingography.

Objective: The aim of this study was to compare the use of a cervical vacuum cap cannula with the traditional metal cannula.

Design: A prospective, randomised, single-blinded comparative study.

Sample: Fifty consecutive infertile women undergoing hysterosalpingography for evaluation of infertility

Methods: Hysterosalpingography was performed either with the traditional metal cannula (n = 25) or a cervical vacuum cap cannula (n = 25).

The accuracy of serum interleukin-6 and tumour necrosis factor as markers for ovarian torsion.

Background: The aim of this study was to investigate a possible role for interleukin-6 (IL-6) and tumour necrosis factor (TNF-alpha) as pre-operative markers for the diagnosis of ovarian torsion.

Methods: Twenty consecutive patients admitted to the gynaecological emergency room with suspected clinical diagnosis of ovarian torsion were prospectively assigned to the study. Blood samples were drawn pre-operatively and examined for serum concentrations of IL-6 and TNF-alpha.

Sonohysterography for the diagnosis of residual trophoblastic tissue.

Objective: To assess the efficacy, safety, and associated complications of sonohysterography for the diagnosis of residual trophoblastic tissue.

Methods: We conducted a prospective study of 23 consecutive patients admitted to our ultrasonography unit with clinical and ultrasonographic signs of retained intrauterine tissue.

Results: Twelve patients had hydrosonographic features suggestive of residual trophoblastic tissue (i.

A comparative study of multifetal pregnancy reduction from triplets to twins in the first versus early second trimesters after detailed fetal screening.

Objectives: To compare the outcome of multifetal pregnancy reduction from triplets to twins performed either early (at 11-12 weeks' gestation) or late (at 13-14 weeks).

Methods: Ninety-five high-order pregnancies following assisted conception were studied. Transabdominal sonographically guided multifetal pregnancy reduction was performed early in 46 women, while 49 women first underwent a sonographic fetal anomaly scan before undergoing selective reduction.

Prediction of hyperbilirubinemia in near-term and term infants.

Objective: The purpose of this study was to determine whether end-tidal carbon monoxide (CO) corrected for ambient CO (ETCOc), as a single measurement or in combination with serum total bilirubin (STB) measurements, can predict the development of hyperbilirubinemia during the first 7 days of life.

Methods: From 9 multinational clinical sites, 1370 neonates completed this cohort study from February 20, 1998, through February 22, 1999. Measurements of both ETCOc and STB were performed at 30 +/- 6 hours of life; STB also was measured at 96 +/- 12 hours and subsequently following a flow diagram based on a table of hours of age-specific STB.

Management of a triplet pregnancy with two anencephalic fetuses and polyhydramnios.

The occurrence of a triplet pregnancy discordant for anencephaly is rare and its management presents a clinical dilemma. We report what appears to be the first case of a triplet pregnancy with two anencephalic fetuses complicated by premature contractions and severe polyhydramnios. Its management, which results a healthy newborn weighing 1385 g is discussed.

Hysteroscopy may be the method of choice for management of residual trophoblastic tissue.

Study Objective: To assess the efficacy of and reproductive outcome after selective curettage of residual trophoblastic tissue directed by hysteroscopy compared with conventional, nonselective, blind curettage.

Design: Retrospective analysis (Canadian Task Force classification II-1).

Setting: Tertiary care medical center.