First-trimester screening for chromosomal abnormalities by integrated application of nuchal translucency, nasal bone, tricuspid regurgitation and ductus venosus flow combined with maternal serum free ß-hCG and PAPP-A: a 5-year prospective study.

OBJECTIVE: To investigate the performance of first-trimester screening for chromosomal abnormalities by integrated application of nuchal translucency thickness (NT), nasal bone (NB), tricuspid regurgitation (TR) and ductus venosus (DV) flow combined with maternal serum free ß-human chorionic gonadotropin (fß-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at a one-stop clinic for assessment of risk (OSCAR). METHODS: In total, 13,706 fetuses in 13,437 pregnancies were screened for chromosomal abnormalities during a period of 5 years. Maternal serum biochemical markers and maternal age were evaluated in combination with NT, NT + NB, NT + NB + TR, and NT + NB + TR + DV flow data in 8581, 242, 236 and 4647 fetuses, respectively. RESULTS: In total, 51 chromosomal abnormalities were identified in the study population, including 33 cases of trisomy 21, eight of trisomy 18, six of sex chromosome abnormality, one of triploidy and three of other unbalanced abnormalities. The detection rate and false-positive rate (FPR) for trisomy 21 were 93.8% and 4.84%, respectively, using biochemical markers and NT, and 100% and 3.4%, respectively, using biochemical markers, NT, NB, TR and DV flow. CONCLUSION: While risk assessment using combined biochemical markers and NT measurement has an acceptable screening performance, it can be improved by the integrated evaluation of secondary ultrasound markers of NB, TR and DV flow. This enhanced approach would decrease the FPR from 4.8 % to 3.4 %, leading to a lower number of unnecessary invasive diagnostic tests and subsequent complications, while maintaining the maximum level of detection rate. Pre- and post-test genetic counseling is of paramount importance in either approach.

Fertility sparing in young women with ovarian tumors.

BACKGROUND: Surveys have shown that fertility sparing in patients with ovarian tumors has proven to be effective. Thus this approach in ovarian tumor cases has been carried out. The purpose of this study was to evaluate the clinical outcome and pregnancies in women who suffered from ovarian tumor and underwent conservative treatment. MATERIALS AND METHODS: All cases who received conservative treatment and those who had recurrence of the disease during the follow-up period were evaluated at Vali-Asr Hospital from 2000-2004. RESULTS: 60 of 410 patients with ovarian tumor (age range: 13-34) were treated conservatively. Three patients (5%) were infertile. Histology of tumors showed: 26 (43.3%) germ cell tumors, 15 (25%) borderline tumors, ten (16.7%) epithelial tumors and nine (15%) sex cord tumors. The cases were followed for 12-48 months. Seven term pregnancies occurred in six patients. Three in the borderline group, two in the germ cell group, one in the epithelial group and one in the sex-cord group. Nine recurrences were reported among our cases. Two of the patients (serous carcinoma and immature teratoma, both Stage IIIc) died during follow-up due to refusal to undergo radical surgery. CONCLUSION: Fertility preserving surgery in young women with epithelial ovarian tumors, borderline and sex-cord tumors Stage I, grade 1 and 2 is recommended.

Postpartum evaluation of stress urinary incontinence among primiparas.

OBJECTIVE: To assess the prevalence of postpartum stress urinary incontinence (SUI); the relationship between postpartum SUI and mode of delivery; and the association between SUI and other obstetric factors. METHOD: In this prospective study, 1000 primiparas with no history of UI were recruited and followed up for 4 months after delivery. The chi(2) and Fisher's Exact tests were used to calculate the effects of the nominal variables. RESULT: The prevalence of postpartum SUI was 14.1%, and the mode of delivery was significantly associated with SUI. The prevalence rates were 15.9% after vaginal delivery, 10.7% after elective cesarean section (CS), and 25% after CS performed for obstructed labor. The prevalence of postpartum SUI was similar following spontaneous vaginal delivery and CS performed for obstructed labor (P=.21). Meanwhile, elective CS with no trial of labor was found to be associated with a significantly lower prevalence of postpartum SUI (P=.01; chi(2)=12.42). A maternal body mass index greater than 30 before pregnancy and fetal weight higher than 3000 g appeared to be associated with an increased rate of SUI (P=.001; chi(2)=17.6 and P=.000; chi(2)=22.5, respectively). CONCLUSION: Elective CS significantly reduced the rate of postpartum SUI.

Effects of microwave heat, packaging, and storage temperature on fatty acid and proximate compositions in rice bran.

The effect of microwave heat, packaging methods, and storage temperatures on proximate and fatty acid compositions of rice bran during 16 weeks of storage was examined. Freshly milled raw rice bran was adjusted to 21% moisture content and microwave heated for 3 min. Raw and microwave-heated brans were packed in zipper-top bags and/or vacuum-sealed bags and stored at 4-5 and/or 25 degrees C for 16 weeks. The moisture content decreased significantly from an initial 8.4 to 6.4% in microwave-heated samples regardless of packaging methods and storage temperatures. Protein, fat, linoleic, and linolenic contents did not change significantly in all raw and microwave-heated samples during 16 weeks of storage. The microwave-heated rice bran packed in zipper-top bags can be stored at 4-5 degrees C for up to 16 weeks without adverse effect on proximate and fatty acid composition quality under the conditions employed in this study.

Prevention of oxidative rancidity in rice bran during storage.

The effect of microwave heat on lipoxygenase (LOX) activity in rice bran under various storage conditions was examined. Raw rice bran from the long-grain variety Lemont was adjusted to 21% moisture content and heated in a microwave oven at 850 W for 3 min. Raw and microwave-heated rice bran samples were packed in zipper-top bags or vacuum packs and stored at room temperature (25 degrees C) or in the refrigerator (4-5 degrees C) for 16 weeks. Samples were analyzed for LOX activity at 4-week intervals. LOX activity did not significantly change from its initial value at week 0 for zipper-top and vacuum-packed samples while stored at 4-5 degrees C for 12 weeks, but decreased at week 16. Vacuum packing did not show a significant impact on LOX activity during 16 weeks of storage. Microwave-heated samples stored in the refrigerator did not show significant change in LOX activity for up to 12 weeks but showed a significant (p < 0. 05) decrease at 16 weeks. Results showed that oxidative rancidity of rice bran could be prevented by microwave heating the samples, packing in zipper-top bags, and storing at 4-5 degrees C for up to 16 weeks.

Prevention of hydrolytic rancidity in rice bran during storage.

The effect of microwave heating, packaging, and storage temperature on the production of free fatty acids (FFA) in rice bran was examined. Freshly milled raw rice bran was adjusted to 21% moisture content and heated in a microwave oven at 850 W for 3 min. Raw and microwave-heated rice bran were packed in zipper-top bags or vacuum-sealed bags and stored at 4-5 or 25 degrees C for 16 weeks. FFA content of bran was measured at 4-week intervals. Total FFA increased rapidly over the 16-week period from the initial value of 2.5% in raw bran stored at 25 degrees C to 54.9% in vacuum bags and 48.1% in zipper-top bags. However, total FFA of raw bran stored at 4-5 degrees C increased at a slower rate from an initial value of 2. 5 to 25.4% in vacuum bags and 19.5% in zipper-top bags. After 16 weeks of storage, total FFA of microwave-heated bran stored at 25 degrees C increased from 2.8 to 6.9 and 5.2%, respectively, for samples stored in vacuum bags and zipper-top bags. Total FFA of microwave-heated samples stored at 4-5 degrees C did not change significantly with storage time. Results showed that hydrolytic rancidity of rice bran can be prevented by microwave heating and that the recommended storage condition for microwaved rice bran is 4-5 degrees C in zipper-top bags.

Impact of body mass index versus physical activity and calorie intake on assisted reproduction outcomes.

OBJECTIVE: To measure the effect of body mass index (BMI) versus calorie intake and physical activity (PA) on the outcomes of assisted reproductive technologies (ART). STUDY DESIGN: A prospective study was performed on 236 infertile women who underwent in vitro fertilization. BMI, level of PA and calorie intake were assessed at study entry, and associations between these variables and ART outcomes were analyzed. Participants were divided into four groups based on BMI and PA: normal BMI/inactive, normal BMI/active, overweight/inactive and overweight/active. RESULTS: BMI, adjusted for age, level of PA, calorie intake and aetiology of infertility, was not associated with the number of oocytes retrieved, fertilization rate, cleavage rate, number of embryos, number of high-quality embryos or pregnancy rate. For women aged <36 years, the number of oocytes retrieved and the number of embryos decreased with increasing BMI, independent of calorie intake and PA. The fertilization rate, cleavage rate, number of high-quality embryos and pregnancy rate were not associated with BMI. The number of oocytes retrieved was significantly higher in women of normal weight compared with overweight women, regardless of the level of PA. CONCLUSIONS: Age has a strong negative effect on ART parameters. Increased BMI, independent of calorie intake and PA, has an adverse effect on the number of oocytes retrieved in women aged <36 years, but does not affect the number of high-quality embryos or the success of the treatment cycle.