1,894 research outputs found
Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility
No full textCopyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.Background Polycystic ovary syndrome (PCOS) is characterised by anovulation, hyperandrogaenemia and insulin resistance. Hyperinsulinaemia is associated with an increase in cardiovascular risk and the development of diabetes mellitus. If insulin sensitising agents such as metformin are effective in treating features of PCOS, then they could have wider health benefits than just treating the symptoms of the syndrome. Objectives To assess the effectiveness of insulin sensitising drugs in improving reproductive outcomes and metabolic parameters for women with PCOS and menstrual disturbance. Search strategy We searched the Cochrane Menstrual Disorders & Subfertility Group trials register (searched September 2008), the Cochrane Central Register of Controlled Trials (Cochrane Library, third Quarter 2008), CINAHL (searched September 2008), MEDLINE (January 1966 to September 2008), and EMBASE (January 1985 to September 2008). All searches were rerun 13 August 2009 17 RCTs were located and await classification. Selection criteria Randomised controlled trials which investigated the effect of insulin sensitising drugs compared with either placebo or no treatment, or compared with an ovulation induction agent. Data collection and analysis Thirty one trials (2537 women) were included for analysis, 27 of them using metformin and involving 2150 women. Main results There is no evidence that metformin improves live birth rates whether it is used alone (Pooled OR = 1.00, 95% CI 0.16 to 6.39) or in combination with clomiphene (Pooled OR = 1.48, 95% CI 1.12 to 1.95). However, clinical pregnancy rates are improved for metformin versus placebo (Pooled OR = OR 3.86, 95% C.I. 2.18 to 6.84) and for metformin and clomiphene versus clomiphene alone (Pooled OR =1.48, 95% C.I. 1.12 to 1.95) ). In the studies that compared metformin and clomiphene alone, there was no evidence of an improved live birth rate (OR= 0.67, 95% CI 0.44 to 1.02) but the pooled OR resulted in improved clinical pregnancy rate in in the clomiphene group (OR = 0.63 , 95% 0.43 to 0.92), although there was significant heterogeneity. There is also evidence that ovulation rates are improved with metformin in women with PCOS for metformin versus placebo (Pooled OR 2.12, 95% CI 1.50 to 3.0) and for metformin and clomiphene versus clomiphene alone (Pooled OR = 3.46, 95% CI 1.97 to 6.07). Metformin was also associated with a significantly higher incidence of gastrointestinal disturbance, but no serious adverse effects were reported. Authors' conclusions In agreement with the previous review, metformin is still of benefit in improving clinical pregnancy and ovulation rates. However, there is no evidence that metformin improves live birth rates whether it is used alone or in combination with clomiphene, or when compared with clomiphene. Therefore, the use of metformin in improving reproductive outcomes in women with PCOS appears to be limitedThomas Tang, Jonathan M Lord, Robert J Norman, Ephia Yasmin and Adam H Bale
On the conceptual feasibility of a CAAD-CAAI integrated decision support system: A computer aided environment for technical decision-making in architecture
No full textArchitectur
Consensus on women's health aspects of polycystic ovary syndrome (PCOS)
No full textPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in females with a high prevalence. The etiology of this heterogeneous condition remains obscure and its phenotype expression varies. Two, widely cited, previous ESHRE/ASRM-sponsored PCOS consensus workshops focused on diagnosis (published in 2004) and infertility management (published in 2008). The present third PCOS consensus paper summarizes current knowledge and identifies knowledge gaps regarding various women’s health aspects of PCOS. Relevant topics addressed—all dealt with in a systematic fashion—include adolescence, hirsutism and acne, contraception, menstrual cycle abnormalities, quality of life, ethnicity, pregnancy complications, long-term metabolic and cardiovascular health and finally cancer risk. Additional, comprehensive background information is provided separately in an extended online publication.B.C.J.M. Fauser, B.C. Tarlatzis, R.W. Rebar, R.S. Legro, A.H. Balen, R. Lobo, H. Carmina, R.J. Chang, B.O. Yildiz, J.S.E. Laven, J. Boivin, F. Petraglia, C.N. Wijeyeratne, R.J. Norman, A. Dunaif, S. Franks, R.A. Wild, D. Dumesic and K. Barnhar
A letter to A.H. Esq., concerning the stage [electronic resource]
No full textA defense of the stage, in answer to Jeremy Collier's Short view of the immorality and profaneness of the English stage."The initials in the title [i.e. A.H.] have been identified as those of Anthony Hammond. Charles Hopkins has been suggested as the probable author." Cf. NUC pre-1956.Reproduction of original in Huntington Library.WingElectronic reproduction
De kosten van een zandsuppletie op het strand van de Kop van Goeree uitgevoerd met behulp van de zogenaamde "Punaise"
No full textIn het 1e deel van het afstudeerverslag van A.H. van Berk (lit. 1) werd de vraag gesteld of een baggersysteem voor het kustonderhoud van de Kop van Goeree met de punaise (fig. 0) in één van de wingebieden A, B of C (fig. 2) kan konkurreren met een systeem met een cutterzuiger in wingebied E. Voor het antwoord op deze vraag zijn de kosten van zowel de uitvoering met de punaise als die met de cutterzuiger bepaald. Deze kosten zijn omgerekend naar de gemiddelde jaarlijkse kosten voor het kustonderhoud en onderling vergeleken. In het tweede deel wordt een handleiding gegeven voor de berekening van de jaarlijkse kosten van het kustonderhoud van de lop van Goeree door zandsuppietie a.b.v. de Punaise.Hydraulic EngineeringCivil Engineering and Geoscience
Determinanten van kennisintensieve onderzoeks- en ontwikkelingssamenwerking
No full textIt is becoming increasingly important for companies to ensure a continuing supply of new knowledge. The development of innovative production processes and marketing strategies as well as better products and services improves the competitive position of firms on the world market. This is of special interest to Dutch firms who have only a small and open home market. The principal research question addressed in this thesis concerns the determinants that influence companies in their choice of whether or not to enter into a knowledge-intensive research and development collaboration. This thesis also looks in detail at the role of publicly financed research institutions such as universities, in the setting of the company innovation process as well as at cooperation among private firms. About 13% of all innovative firms in the Netherlands are engaged in some sort of knowledge-intensive research and development collaboration. Knowledge spillovers are an important reason to reject collaboration as a means of acquiring knowledge because spillovers worsen the appropriability conditions, thus decreasing the economic benefits gained from innovative efforts. In correspondence with the literature we find that a high level of R&D-intensity of the partners involved is a very important prerequisite for entering into knowledge intensive R&D-collaboration. Furthermore an important finding is that the probability of entering into a knowledge-intensive R&D-collaboration increases proportionally to the size of the firm. Most innovative firms choose to be engaged in both private and public types of knowledge intensive R&D-collaboration. From this it can be concluded that public and private types of collaboration are complementary to one another. Knowledge intensive R&D-collaboration is also of strategic importance making the decision whether to introduce either improved or newly-developed products onto the market. Firms engaged in knowledge intensive R&D-collaboration more often choose to introduce new products instead of improved products onto the market.Technology, Policy and Managemen
Experiments on nulcides decaying by position emission and electron caputure
No full textApplied Science
Metingen met een proportionele teller bij beta-desintegratie
No full textElectrical Engineering, Mathematics and Computer Scienc
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