OVARIAN STIMULATION IN ASSISTED REPRODUCTION Marija Gačić; Helena Meden Vrtovec; Veljko Vlaisavljević
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2018, Letnik:
78
Journal Article
Recenzirano
Odprti dostop
Background. It has passed more than 50 years from the developmental phase of ovulation induction. During this period new medications have been introduced, new protocols and dosage established, but ...the regimen, that would suit all women, has not been designed yet. Methods. The success of ovulation induction in assisted reproduction technologies (ART) does not depend only on medications used, but is influenced by contributing key factors, such as woman’s age, characteristics of the menstrual cycle, body mass index, ovarian reserve and concomitant diseases. The first successful pregnancy followed ART in natural cycle without medications. Because of a relatively low success rate natural cycle was replaced in 70’s by protocols that included clomiphene-citrate or gonadotropins. The introduction of gonadoliberin agonists represented the greatest advantage in this field. The use of human menopausal gonadotropins and recombinants: recombinant FSH, recombinant LH and recombinant HCG in combination with GnRH agonists resulted in significantly higher pregnancy rate (cumulative up to 65 %), but also higher multiple pregnancy rate and ovarian hyperstimulation rate. That is why cheaper, less complicated and patient friendly principles have been renewed, including natural cycle, minimal and mild ovarian stimulation (the use of clomiphene-citrate, letrozole and small doses of HMG or rFSH) that enable ovulation induction and pregnancy in about 30 % of treated women. For a half of the century sophisticated protocols of ovarian stimulation have been developed, but recent European recommendations favour the use of less aggressive, cheaper, effective and patient friendly methods of ovulation induction in ART. There are also protocols for low responding ovaries, which we classify as development of three or less follicles 16 mm in size, only one dominant follicle, or if in past there had been previous cancellations of the cycle because of less than three follicles developed in spite of correct stimulation with gonadotropins. In the literature there are some suggestions how to treat such patients: – long protocol with higher daily doses of gonadotropins, – lowering doses of GnRH agonists or stopping the application soon or immediately after stimulation with gonadotropins has started, – short term use of GnRH agonists in follicular phase, – sequential use of CC and exogene gonadotropins. Ovarian response is monitored by serum estradiol determinations and vaginal ultrasound measurement of follicular size together with echographic estimation of endometrial development. The procedure must comply with each individual and consider her obligations. There should be regular controls, if the dose of gonadotropins is suiting. The application of HCG should be optimized, the hyperstimulation of ovaries should be avoided and the possibility of multiple pregnancies should be lowered. We should also consider the economical side of the use of drugs and the development of the laboratory techniques in reproductive biology. Conclusions. For a half of the century sophisticated protocols of ovarian stimulation have been developed, but recent European recommendations favour the use of less aggressive, effective and patient friendly methods of ovulation induction in ART
The aim was to adapt the Croatian and the Serbian versions of the Oral Health Impact Profile for the edentulous population (OHIP-EDENT-CRO and OHIP-EDENT-SRB).
The translation and cross-cultural ...adaptation were carried out in accordance with accepted international standards. A total of 95 and 177 removable denture wearers were recruited in Croatia and Serbia respectively. The reliability was evaluated by calculating Cronbach's alpha coefficient and by test-retest (30 participants in each country). The concurrent validity was determined by calculating the Spearman's rank coefficient between the OHIP-EDENT summary scores and one question related to removable denture satisfaction. Construct validity was determined by exploratory factor analysis (EFA). Responsiveness was determined by comparison of the OHIP-EDENT summary scores before and after dental implant placement to support mandibular overdentures (23 patients in Croatia, 21 in Serbia).
Cronbach's alpha coefficient was 0.92 in Croatia and 0.87 in Serbia. The intraclass correlation coefficient was 0.98 in Croatia and 0.94 in Serbia. In Croatia the Spearman's correlation coefficient was -0.71 (p<0.001) and in Serbia -0.74 (p<0.001). Both confirmed concurrent validity. Construct validity was tested by EFA, which extracted four factors in each country, accounting for 66.59% of the variance in Croatia and 59.33% in Serbia. Responsiveness was confirmed in both countries by a significant OHIP-EDENT summary score reduction and a high standardised effect size (3.9 in Croatia, 1.53 in Serbia).
The results prove that both instruments, the OHIP-EDENT-CRO and the OHIP-EDENT-SRB, have very good psychometric properties for assessing OHRQoL in the edentulous population.
Odzivnost ponudbe v prašičereji JENKO, Janez; ERJAVEC, Emil
Acta agriculturae slovenica,
12/2006, Letnik:
88, Številka:
2
Journal Article
Recenzirano
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Analizirali smo dejavnike ponudbe praöičev v Sloveniji v obdobju med januarjem 1995 in decembrom 2005. Razvili smo dva sklopa modelov, ki pojasnjujeta trûne količine prodane ûive mase praöičev. Prvi ...sklop pojasnjuje odzivnost ponudbe praöičev z realnimi cenami, drugi sklop pa na podlagi doseûenih pokritij. Uporabili smo standardno Cobb-Douglasovo obliko profitne funkcije. Modeli so razviti na podlagi metode navadnih najmanjöih kvadratov in ustreznih testov. S testiranjem različnih oblik modelov in znotraj njih različnih odlogov eksogenih spremenljivk smo razvili dva modela. Modela pojasnjujeta najviöji deleû variabilnosti količinskega odkupa ûive mase praöičev v Sloveniji ob upoötevanju statistične značilnosti parametrov in celotnega modela. Rezultati so pokazali, da ima največji vpliv na ponudbo praöičev cena ûive mase praöičev oziroma doseûeno pokritje v praöičerejski proizvodnji in cena koruze, ki tudi v Sloveniji predstavlja glavni vloûek v reji praöičev. Med drugimi statistično značilnimi vplivi omenimo öe vpliv sezone in nekaterih nepredvidljivih vplivov, kot sta vpliv prisotnosti pojava bolezni BSE ter vpliv krize na trgu s praöičjim mesom. Vrednosti koeficientov lastne cenovne elastičnosti so bile pričakovano nizke in so znaöale okoli 0,3 ter tako potrdile tezo o neelastičnosti ponudbe praöičev. Dobljene vrednosti lahko razloûimo z neprilagoditvami trûnim razmeram in prisotnostjo kvazi-fiksnih stroökov v praöičereji.
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