Salivary progesterone as an index of the luteal function

Salivary progesterone (SP) is proposed as a useful index for estimation of luteal function. In 32 normal luteal phases with in-phase endometrial biopsies, the luteal SP assayed three times between 11 and 4 days before menses correlated significantly with the matched plasma P (PP) values and the ratio of SP to PP X 100 = 1.02. In 19 disharmonic luteal phases, a syndrome characterized by retarded endometrial development and apparently normal corpus luteum function, SP and PP were both in the normal range. In five conception cycles, SP and PP correlated significantly and increased during the evolution of the corpus luteum of pregnancy. In four cycles of luteal insufficiency, P concentrations were lower than normal in saliva as well as in plasma.     

Learning the ropes together: assimilation and friendship development among first-year male medical students

This study explores the mutual influences of friendship development and organizational assimilation processes among first-year male medical students. Interviews and observations were used to examine the ways students constructed and enacted their friendships with male classmates during the process of assimilating into medical school. The study also examined how the male friends viewed the influence of their friendships on their assimilation into medical school and how the assimilation process simultaneously influenced their developing friendships. Thematic analysis revealed that although the men perceived their medical school friendships as "not yet close," the friendships provided them with valuable tangible and socio-emotional support during the rigorous assimilation process and that the assimilation process paradoxically facilitated as well as hindered the development of friendships. Implications for practice and future research are discussed.     

Sarcoidosis and mononuclear phagocytes

Sarcoidosis is frequently associated with elevations of serum levels of either lysozyme or angiotensin-converting enzyme or both. Elevation of serum lysozyme probably derives from increased monocyte secretion of lysozyme and from increases in the lysozyme activity of the lung macrophage. Human alveolar macrophages from sarcoidosis patients contain more angiotensin-converting enzyme than normal human alveolar macrophages. The pathogenetic, diagnostic and therapeutic significance of these observations are discussed.     

Low dose recombinant FSH treatment may reduce multiple gestations caused by controlled ovarian hyperstimulation and intrauterine insemination

OBJECTIVE: To evaluate the rate of multiple pregnancies in intrauterine insemination cycles stimulated with a minimal dose of recombinant follicle stimulating hormone (rec-FSH). DESIGN: Retrospective study. SETTING: University Medical Center. POPULATION: A total of 1256 patients underwent 3219 consequent intrauterine insemination cycles with minimal ovarian stimulation. METHODS: Patients received 50 or 75 IU of rec-FSH from day four to day seven. The dose was adjusted according to oestradiol (E(2)) levels in order to achieve a maximum of two follicles on the day of hCG administration. MAIN OUTCOME MEASURES: Peak E(2) levels, the number of follicles >15 mm and pregnancy rates were calculated. The predictive value of E(2) levels for multiple gestations was also estimated. RESULTS: Of 3219 cycles, 334 resulted in pregnancies (10%). Of these, 238 (91%) were singletons, 28 (8%) twins and 1 (0.3%) was a triplet. The cumulative overall pregnancy rate was 43%. Patients over 40 years old had a significantly lower pregnancy rate per cycle and overall live birth rate (P < 0.05). Most pregnancies (83%) occurred during the first three cycles. Pregnancy rates per cycle varied from 8% for tubal factor to 14% for anovulation infertility. CONCLUSIONS: Minimal FSH stimulation in intrauterine insemination cycles may reduce the rates of twins and high order multiple pregnancies without affecting overall pregnancy rates.