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The article discusses a study on the effect of a 2-year period of dietary intervention and changes on the intake of certain food groups on the serum concentration of magnesium, zinc, copper, and selenium. Topics include the Dietary Intervention Randomized Control Trial (DIRECT), low-fat, Mediterranean, and low-carbohydrate diets, and the results which predict that lower intake of sweets and cakes and higher consumption of pasta, cereals, and bread can lead to higher zinc, copper, and selenium.

The study was aimed to define parturients' opinion on either epidural analgesia or intravenous pethidine, and to determine the effect of both analgesics after delivery. We interviewed and examined 401 consecutive parturients who requested analgesia during the beginning of their active stage of labor. Of those, 131 women requested and underwent epidural analgesia, and 270 received parenteral pethidine. The pain experienced before admission of any analgesia, was significantly higher in the epidural group than in the parental group (mean visual analog scale (VAS) score 8.9 and 8.4, respectively; P=0.004). However, after analgesics, women from the epidural analgesia experienced significantly less pain during labor as compared to those receiving pethidine (mean VAS scores 5.05 vs. 9.14, respectively; p<0.001). The pain scores 24 h after labor were significantly lower in patients who underwent epidural analgesia (1.69 vs. 2.13, respectively; p<0.001). We conclude that epidural analgesia is more effective than parenteral analgesia in pain and discomfort relief. This method is helpful also the day after delivery. Thus, epidural analgesia should be strongly recommended to all patients who do not have any medical contraindications to this method of treatment. [ABSTRACT FROM AUTHOR]

The present review was aimed to determine the influence of working conditions, occupational exposures to potential chemical and physical reproductive toxic agents and psychological stress during work on male fertility. Significant associations were reported between impaired semen parameters and the following chemical exposures: metals (lead, mercury), pesticides (dibromochlorophane, 2,4-dichlorophenoxyacetic acid), ethylene glycol ethers and estrogens. The following physical exposures were shown to deteriorate sperm parameters: radiation (both ionized and microwaves) and heat. Psychological distress has another important contribution to infertility. Several studies indicated that stress has a negative impact on sperm parameters. Occupational parameters should be an important part of history taking among patients attending infertility clinics.

Objective: To determine maternal characteristics and perinatal outcomes of unattended out-of-hospital deliveries., Study Design: A population-based study including all singleton deliveries between 1988 and 1999. Maternal characteristics and pregnancy outcomes of accidental out-of-hospital births were compared with those of women who delivered in the hospital. Multiple logistic regression analysis was performed to investigate independent risk factors for out-of-hospital deliveries. Another model was constructed to assess the independent risk of out-of-hospital delivery for perinatal mortality., Results: The incidence of unattended, out-of-hospital deliveries was 2% (2,328/114,938). Multiparity, Bedouin ethnicity and lack of prenatal care were independently associated with out-of-hospital deliveries. Parturients who delivered out of hospital had a significantly lower rate of previous cesarean deliveries. Perinatal mortality was significantly higher among out-of-hospital deliveries, and those newborns were significantly more likely to be small for gestational age as compared to newborns with in-hospital births. In a multivariable model investigating risk factors for perinatal mortality, out-of-hospital delivery was an independent risk factor for perinatal mortality. Other significant risk factors were Bedouin ethnicity and lack of prenatal care., Conclusion: Accidental out-of-hospital birth, associated with multiparity, Bedouin ethnicity and lack of prenatal care, is an independent risk factor for perinatal mortality.