Concentrations sériques de protéines placentaires au 1er trimestre dans des grossesses monofoetales et multiples après FIV : implications pour le dépistage de la trisomie 21 [First trimester serum concentrations of placental proteins in singleton and multiple IVF pregnancies: implications for Down syndrome screening]

First trimester biochemical trisomy screening is based on serum concentrations of pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotrophin (hCG). Our aim was to confirm previously suggested modifications in serum marker concentrations after in vitro fertilisation (IVF) and embryo transfer (ET), and to assess the need of establishing normal medians for trisomy screening in these. We compared 56 singleton pregnancies obtained after ET (of which 40 in gonadotrophin stimulation cycles) with 120 gestation-matched spontaneous controls. For multiple pregnancies, 17 treated cycles were compared with 25 controls. The levels of PAPP-A, hCG, and pregnancy-specific β1-glycoprotein were determined and compared between treated and spontaneous pregnancies. Serum PAPP-A levels were reduced in pregnancies achieved after gonadotrophin-stimulated IVF and ET, and this was more pronounced in earlier gestational stages. SP1 followed the same trend, while hCG tended to be increased, and this not only in pregnancies obtained from gonadotrophin-stimulated but also from oestrogen supported cycles, and with a more pronounced effect in the later gestational ages examined here. Decreased PAPP-A together with increased hCG concentrations produce falsely elevated results in first trimester Down syndrome screening, but we do not recommend the establishment of normal medians for IVF pregnancies due to the variations in stimulation protocols.

Iowa Department of Transportation Major Items - Preliminary Quantity Report, October 21, 2014; With Addendums

Weekly letting report.

List of Bid Proposal Holders, October 21, 2014

List of Bid Proposal Holders

Iowa Agri-News, September 18, 2014, Vol. 14, no. 21

Crop and livestock summaries for the state of Iowa, produced by the Iowa Department of Agriculture. Previously Agri-News

Arrest du Conseil d'Etat du Roi,qui ordonne la liquidation des offices ci-devant créés pour le parlement de Paris, le Grand-Conseil & la Cour des Aides ; et qui fixe & assigne les fonds & l'ordre pour le remboursement desdits offices. Du 21 avril 1771. Extrait des registres du Conseil d'Etat

[Acte. 1771-04-21. Versailles]

Oeuvres complètes de J. Michelet. T.21, 5

Comprend : Oeuvres choisies de Vico

Iowa Department of Transportation Major Items - Preliminary Quantity Report, January 21, 2015; With Addendums

Weekly letting report.

Friday Facts, November 21, 2014, Vol. 234

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Iowa Living Roadways:Plant Profiler, August 21,2013

This publication is a guide to understanding the Iowa Department of Transportation’s roadside management programs. It offers descriptions of various landscape designs or planting styles used within or adjacent to Iowa’s highway rights-of-way, as well as various plant profiles. In addition, this guide will help you learn more about the value of plants and their contribution to our environment and society. This publication is written for persons having little or no formal training in botany, and technical terminology has been kept to the minimum necessary to maintain standards of accuracy and conciseness in the descriptions.

Water Summary Update, May 21, 2014, No. 36

A snapshot of water resource trends prepared by the Iowa DNR in collaboration with the Iowa Department of Agriculture and Land Stewardship, the U.S. Geological Survey, and The Iowa Homeland Security and Emergency Management Department.

Water Summary Update, April 4, 2013, No. 21

A snapshot of water resource trends prepared by the Iowa DNR in collaboration with the Iowa Department of Agriculture and Land Stewardship, the U.S. Geological Survey, and The Iowa Homeland Security and Emergency Management Department.

Farm Families Alive and Well, December 2014, Vol. 21, no. 1

News from Iowa’s Center for Agricultural Safety and Health (I-CASH)

Modelling Bone Mineral Density in Swiss Breast Cancer Patients Treated with Letrozole, Tamoxifen and Sequences of Letrozole and Tamoxifen in the BIG 1-98 Study (SAKK 21/07).

Background: Bone health is a concern when treating early stage breast cancer patients with adjuvant aromatase inhibitors. Early detection of patients (pts) at risk of osteoporosis and fractures may be helpful for starting preventive therapies and selecting the most appropriate endocrine therapy schedule. We present statistical models describing the evolution of lumbar and hip bone mineral density (BMD) in pts treated with tamoxifen (T), letrozole (L) and sequences of T and L. Methods: Available dual-energy x-ray absorptiometry exams (DXA) of pts treated in trial BIG 1-98 were retrospectively collected from Swiss centers. Treatment arms: A) T for 5 years, B) L for 5 years, C) 2 years of T followed by 3 years of L and, D) 2 years of L followed by 3 years of T. Pts without DXA were used as a control for detecting selection biases. Patients randomized to arm A were subsequently allowed an unplanned switch from T to L. Allowing for variations between DXA machines and centres, two repeated measures models, using a covariance structure that allow for different times between DXA, were used to estimate changes in hip and lumbar BMD (g/cm2) from trial randomization. Prospectively defined covariates, considered as fixed effects in the multivariable models in an intention to treat analysis, at the time of trial randomization were: age, height, weight, hysterectomy, race, known osteoporosis, tobacco use, prior bone fracture, prior hormone replacement therapy (HRT), bisphosphonate use and previous neo-/adjuvant chemotherapy (ChT). Similarly, the T-scores for lumbar and hip BMD measurements were modeled using a per-protocol approach (allowing for treatment switch in arm A), specifically studying the effect of each therapy upon T-score percentage. Results: A total of 247 out of 546 pts had between 1 and 5 DXA; a total of 576 DXA were collected. Number of DXA measurements per arm were; arm A 133, B 137, C 141 and D 135. The median follow-up time was 5.8 years. Significant factors positively correlated with lumbar and hip BMD in the multivariate analysis were weight, previous HRT use, neo-/adjuvant ChT, hysterectomy and height. Significant negatively correlated factors in the models were osteoporosis, treatment arm (B/C/D vs. A), time since endocrine therapy start, age and smoking (current vs. never).Modeling the T-score percentage, differences from T to L were -4.199% (p = 0.036) and -4.907% (p = 0.025) for the hip and lumbar measurements respectively, before any treatment switch occurred. Conclusions: Our statistical models describe the lumbar and hip BMD evolution for pts treated with L and/or T. The results of both localisations confirm that, contrary to expectation, the sequential schedules do not seem less detrimental for the BMD than L monotherapy. The estimated difference in BMD T-score percent is at least 4% from T to L.