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Balen AH, Laven JSE, Tan S-L and Dewailly D 2003 ; Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 9, 505514. Barnes FL, Crombie A, Gardner DK, Kausche A, Lacham-Kaplan O, Suikkari A-M, Tiglias J, Wood C and Trounson A 1995 ; Blastocyst development and birth after in-vitro maturation of human primary oocytes, intracytoplasmic sperm injection and assisted hatching. Hum Reprod 10, 3243 3247. Barnes FL, Kausche A, Tiglias J, Wood C, Wilton L and Trounson AO 1996 ; Production of embryos from in vitro-matured primary human oocytes. Fertil Steril 65, 11511156. Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY and Yoon TK 1991 ; Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril 55, 109113. Cha KY, Han SY, Chung HM, Choi DH, Lim JM, Lee WS, Ko JJ and Yoon TK 2000 ; Pregnancies and deliveries after in vitro maturation culture followed by in vitro fertilization and embryo transfer without stimulation in women with polycystic ovary syndrome. Fertil Steril 73, 978983. Check JH, Nowroozi K, Choe J, Lurie D and Dietterich C 1993 ; The effect of endometrial thickness and echo pattern on in vitro fertilization outcome in donor oocyte-embryo transfer cycles. Fertil Steril 59, 7275.
Abstract Although not yet recommended, regimens combining both a non-nucleoside reverse transcriptase inhibitor NNRTI ; and protease inhibitors PI ; can be used as first-line therapy, or as second-line or salvage therapy in patients who need to change antiretroviral treatment because of nucleoside reverse transcriptase inhibitors NRTI ; intolerance or virological failure with resistance to NRTI. Such combinations should not be used in patients infected with HIV-1 group O and HIV-2, due to the natural resistance to NNRTI of these subtypes. Dual NNRTI and PI combinations used as first-line therapy allow to spare NRTI, leaving a fully active class of drugs for later use, and delaying the risk of toxicity related to NRTI exposure, particularly mitochondrial toxicity. Several studies have shown that adding a NNRTI improves the efficacy of a second-line or salvage therapy based on a new combination of PI s ; and new or recycled NRTI s ; . A possible explanation for the efficacy of NNRTI-containing regimens in NRTI-pretreated patients is that mutations conferring resistance to NRTI can increase the susceptibility of the viruses to the NNRTI. However, the decision to use a NNRTI in a salvage regimen needs to be weighed against the concern that subsequent failure will exhaust therapeutic options with any compound of this class, due the large degree of cross-resistance between the three available NNRTI. NNRTI and PIs are extensively metabolized in the liver through cytochrome P450, leading to pharmacokinetic interactions. The decrease in PIs plasma concentrations observed when they are combined with nevirapine or efavirenz is reduced when low doses of ritonavir, which strongly inhibits cytochrome P450, are associated with the combination of PI and NNRTI.

Figure 2. Response of pulmonary vascular resistance PVR ; and systemic arterial pressure SAP ; to inhalation of treprostinil versus iloprost: dose effects. A ; Inhalation of 7.5 g iloprost in 6 min ; versus 7.5 g treprostinil 6 min ; n 14, in randomized order ; . B ; Inhalation of 7.5 g iloprost 6 min ; versus 15 g treprostinil 6 min ; n 14, in randomized order ; . C ; Inhalation of 7.5 g iloprost 6 min ; versus 15 g treprostinil 3 min ; n 16, in randomized order ; . Data are shown as percent of baseline values mean 95% confidence interval ; . Circles iloprost; triangles treprostinil.

Surrogate Motherhood Examine with us for a moment that last item--surrogacy. Think back to an earlier time in American history, when blood seeped from scab-covered wounds left by the heavy chains that once bound the woman's feet. Her joints ached and burned from the long walk that brought her to this endless farmland. From the first glimmer of morning light until the Sun dipped below the horizon, this woman was kept busy obeying the commands of a person to whom she referred simply as "Mas ter." But the most heart-rending concern at the forefront of her mind was the secret that she had kept for many weeks-- her unborn child. Soon, her body would begin to show the physical signs of pregnancy, and she knew that at some point, her master would realize her condition. Her heart broke at the thought of someone else owning her child, and yet she knew it was inevitable. After carrying the child for nine months, the day would come when she would deliver it, and it would become someone else's property. Scenes such as this one were repeated countless times in America prior to the Civil War. Today, we cannot imagine what those grief-stricken women went through behind all those tears, as they turned over their children, knowing they might never see them again. And yet, even now laws are being in troduced in states all across America that once again are mak ing this emotional separation a legal reality. Surrogacy is a common practice in the United States in the twenty-first cen tury. Years ago, the idea of allowing a stranger to carry and deliver a child, only to then give it up, was unknown. Most people stilled believed the words of the psalmist, who wrote: "Lo, children are a heritage of the Lord: and the fruit of the womb is his reward" Psalm 127: 3 ; . That "fruit of the womb" was cherished; thus, very few women ever considered giving up a child who had begun a life in their own womb. The words "surrogate mother" were met with gasps and repulsive looks of shock. However, in today's politically cor rect climate, those words have taken on a completely new light--that of a compassionate act of altruism. Research indi cates that most individuals who serve as surrogate mothers - 122.

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