Triplet pregnancies--a three-decade perspective: do we fare better?

Objectives: To evaluate the impact of advances in perinatal and neonatal care in the past three decades on the outcome of triplet pregnancies.

Study Design: We compared the outcome of 29 sets of triplets born in our medical center during 1978-1987 with 34 sets of triplets born in the same medical center during 2001-2011. Data were extracted from maternal and neonatal medical records.

RING-type E3 ligases: master manipulators of E2 ubiquitin-conjugating enzymes and ubiquitination.

RING finger domain and RING finger-like ubiquitin ligases (E3s), such as U-box proteins, constitute the vast majority of known E3s. RING-type E3s function together with ubiquitin-conjugating enzymes (E2s) to mediate ubiquitination and are implicated in numerous cellular processes. In part because of their importance in human physiology and disease, these proteins and their cellular functions represent an intense area of study.

Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle.

Ectopic pregnancy is a known risk for patients treated with IVF. The objective of this study was to evaluate the effect of methotrexate (MTX) and laparoscopic salpingectomy as treatments of ectopic pregnancy on ovarian response during IVF cycles. Data of all women treated for ectopic pregnancy as a result of IVF treatment were evaluated; the study included women who had an unruptured ectopic pregnancy after IVF treatment that was treated with either MTX or laparoscopic salpingectomy and underwent a subsequent IVF cycle.

Global convergence of the EM algorithm for unconstrained latent variable models with categorical indicators.

Convergence of the expectation-maximization (EM) algorithm to a global optimum of the marginal log likelihood function for unconstrained latent variable models with categorical indicators is presented. The sufficient conditions under which global convergence of the EM algorithm is attainable are provided in an information-theoretic context by interpreting the EM algorithm as alternating minimization of the Kullback-Leibler divergence between two convex sets. It is shown that these conditions are satisfied by an unconstrained latent class model, yielding an optimal bound against which more highly constrained models may be compared.

The effect of delayed initiation of gonadotropin-releasing hormone antagonist in a flexible protocol on in vitro fertilization outcome.

Objective: To determine the proportion of patients stimulated on a flexible GnRH antagonist regimen who meet the criteria for antagonist administration after stimulation day 6 (S6) and to compare their clinical characteristics and cycle outcome with those patients who start the antagonist on S6 or earlier.

Design: Retrospective study.

Setting: Tertiary university hospital.

Differential regulation of HMG-CoA reductase and Insig-1 by enzymes of the ubiquitin-proteasome system.

The endoplasmic reticulum (ER)-resident enzyme 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase catalyzes the rate-limiting step in sterol production and is the therapeutic target of statins. Understanding HMG-CoA reductase regulation has tremendous implications for atherosclerosis. HMG-CoA reductase levels are regulated in response to sterols both transcriptionally, through a complex regulatory loop involving the ER Insig proteins, and posttranslationally, by Insig-dependent protein degradation by the ubiquitin-proteasome system.

Ultrasonographic and clinicopathological features of feline gastrointestinal eosinophilic sclerosing fibroplasia in four cats.

Four cats with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) are described. Clinical signs included decreased appetite, weight loss, vomiting and diarrhea. Bloodwork abnormalities included mild neutrophilia (n = 2) and hyperglobulinemia with concurrent hyperproteinemia (n = 2).

Zygote intrafallopian transfer among patients with repeated implantation failure.

Objective: To summarize the experience of a single center with laparoscopic zygote intrafallopian transfer (ZIFT) performed exclusively among patients with high-order repeated implantation failure (RIF) following in vitro fertilization-embryo transfer (IVF-ET).

Methods: A retrospective cohort study was performed at the Edith Wolfson Medical Center, a tertiary referral university hospital located in Holon, Israel. A group of 176 patients with 8.

Heart rate dynamics during acute pain in newborns.

Autonomic nervous system modulation of heart rate is significantly altered during painful procedures in newborns. Most studies investigating pain employed only linear-based analysis methods, thus ignoring the complex, non-linear nature of heart rate control mechanisms. The emergences of dynamic, nonlinear analysis methods enable us to uncover information embedded in the fluctuations of heart rate not otherwise noticeable.

A ubiquitin-binding rhomboid protease aimed at ERADication.

Proteins are degraded from the ER by endoplasmic reticulum-associated degradation (ERAD). In a recent issue of Molecular Cell, Fleig et al. (2012) describe a role for a ubiquitin-binding rhomboid protease, RHBDL4, in degradation of select ERAD substrates.

Doppler middle cerebral artery peak systolic velocity for diagnosis of neonatal anemia.

Objectives: The peak systolic velocity (PSV) of the middle cerebral artery was found to be predictive of fetal anemia and is routinely applied in the treatment of such fetuses. Our objective was to determine whether a correlation exists between the PSV in the neonatal middle cerebral artery and hemoglobin levels for possible future implementation in clinical practice.

Methods: A prospective study on 151 neonates was conducted, examining their middle cerebral artery PSV concomitantly with their hemoglobin level during the first 36 hours after delivery.

Cullin RING ligases: glommed by glomulin.

Cullin ring ligases (CRLs) constitute the largest group of RING finger ubiquitin ligases. Two recent studies in Molecular Cell describe glomulin as a CRL1 inhibitor that blocks interactions with its ubiquitin-conjugating enzyme (E2) (Duda et al., 2012; Tron et al.

The village/commune safety policy and HIV prevention efforts among key affected populations in Cambodia: finding a balance.

The Village/Commune Safety Policy was launched by the Ministry of Interior of the Kingdom of Cambodia in 2010 and, due to a priority focus on "cleaning the streets", has created difficulties for HIV prevention programs attempting to implement programs that work with key affected populations including female sex workers and people who inject drugs. The implementation of the policy has forced HIV program implementers, the UN and various government counterparts to explore and develop collaborative ways of delivering HIV prevention services within this difficult environment. The following case study explores some of these efforts and highlights the promising development of a Police Community Partnership Initiative that it is hoped will find a meaningful balance between the Village/Commune Safety Policy and HIV prevention efforts with key affected populations in Cambodia.

Stress-induced phosphorylation and proteasomal degradation of mitofusin 2 facilitates mitochondrial fragmentation and apoptosis.

Mitochondria play central roles in integrating pro- and antiapoptotic stimuli, and JNK is well known to have roles in activating apoptotic pathways. We establish a critical link between stress-induced JNK activation, mitofusin 2, which is an essential component of the mitochondrial outer membrane fusion apparatus, and the ubiquitin-proteasome system (UPS). JNK phosphorylation of mitofusin 2 in response to cellular stress leads to recruitment of the ubiquitin ligase (E3) Huwe1/Mule/ARF-BP1/HectH9/E3Histone/Lasu1 to mitofusin 2, with the BH3 domain of Huwe1 implicated in this interaction.

Internal medicine trainees' views of training adequacy and duty hours restrictions in 2009.

Purpose: To gauge internal medicine (IM) trainees' perceptions regarding aspects of their inpatient rotations, including supervision, educational opportunities, the perceived effect of duty hours regulations on quality of patient care, the causes of medical errors, and sleep.

Method: The authors analyzed the results of questionnaires administered to trainees following the October 2009 in-training examinations (ITE).

Results: Of the 21,768 IM trainees in postgraduate years 1 through 3 who took the IM-ITE, 18,272 (83.

Alterations of heart rate variability in women with overactive bladder syndrome.

Introduction And Hypothesis: Our objective was to compare autonomic nervous system function between women with an overactive bladder (OAB) and control participants during regulated bladder filling.

Methods: Twenty-four women, nine with OAB and 15 without (control), were instructed to drink 1.5 l of water at a rate of 250 ml every 5 min during continuous electrocardiogram (ECG) monitoring.

Attention mechanisms in children with anxiety disorders and in children with attention deficit hyperactivity disorder: implications for research and practice.

Inattention is among the most commonly referred problems for school-aged youth. Research suggests distinct mechanisms may contribute to attention problems in youth with anxiety disorders versus youth with attention deficit hyperactivity disorder (ADHD). This study compared children (8-17 years) with anxiety disorders (n = 24) and children (8-16 years) with ADHD (n = 23) on neurocognitive tests of both general and emotion-based attention processes.

Human embryonic and induced pluripotent stem cell-derived cardiomyocytes exhibit beat rate variability and power-law behavior.

Background: The sinoatrial node is the main impulse-generating tissue in the heart. Atrioventricular conduction block and arrhythmias caused by sinoatrial node dysfunction are clinically important and generally treated with electronic pacemakers. Although an excellent solution, electronic pacemakers incorporate limitations that have stimulated research on biological pacing.

Dissecting the diverse functions of the metastasis suppressor CD82/KAI1.

The recent identification of metastasis suppressor genes, the products of which inhibit metastasis but not primary tumor growth, distinguishes oncogenic transformation and tumor suppression from a hallmark of malignancy, the ability of cancer cells to invade sites distant from the primary tumor. The metastasis suppressor CD82/KAI1 is a member of the tetraspanin superfamily of glycoproteins. CD82 suppresses metastasis by multiple mechanisms including inhibition of cell motility and invasion, promotion of cell polarity as well as induction of senescence and apoptosis in response to extracellular stimuli.

RINGs of good and evil: RING finger ubiquitin ligases at the crossroads of tumour suppression and oncogenesis.

The ubiquitin-proteasome system has numerous crucial roles in physiology and pathophysiology. Fundamental to the specificity of this system are ubiquitin-protein ligases (E3s). Of these, the majority are RING finger and RING finger-related E3s.