We compared the duration of labor among nulliparous women with varying body mass index (BMI). Laboring nulliparous women at >37 weeks were included. First visit BMI was used to categorize weight as normal (≤24), overweight (25 to 29.9), or obese (≥30 kg/m(2)). Chi-square, one-way analysis of variance, and Bonferroni multiple comparisons tests were used. During 15 months, 375 women met the inclusion criteria, and 38% were obese. Duration of first stage of labor was significantly longer for obese versus normal-weight women (26.76 ± 0.77 versus 23.87 ± 0.66 hours; p = 0.024) but not between normal versus overweight women (p = 1.00) or overweight versus obese women (p = 0.114). The cesarean delivery rate was significantly different in the three groups (p = 0.0001), highest among obese (47%) and lowest in normal-weight women (24%). When adjusted for age, hypertension, and induction, the likelihood of completing stage I was significantly less among obese nulliparous than those with BMI < 24 kg/m(2) (hazard ratio 0.73, 95% confidence intervals 0.54, 0.99). Compared with those with BMI < 24, the duration of stage I is significantly longer among obese women, even when adjusted for maternal age, induction, and hypertension.

Results from this large US cohort provide descriptive information on AE rates in a population of IBD patients undergoing routine care, estimating background incidence rates of AEs that are not readily available in the published literature. Our study findings may be limited owing to a lack of generalizability and potential for misclassification due to reliance on medical diagnosis and treatment and procedure codes to identify disease, comorbidities, and treatments. Further research and validation of our findings in other populations and databases are needed.

The purpose of the study is to examine the effects of polycystic ovary syndrome (PCOS) and body mass index (BMI) on selected indicators of in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment success. A retrospective cohort study was conducted using existing data on 69 IVF/ICSI treatment cycles undergone by PCOS women and an individually matched sample of 69 IVF/ICSI treatment cycles undergone by non-PCOS women at a major fertility treatment center. BMI (kg/m 2 ) was analyzed as a continuous and categorical (< 25, 25−29.9 ≥ 30) variable. Results indicated that PCOS was directly associated with the number of oocytes retrieved. Irrespective of PCOS status, continuous BMI was inversely associated with total and mature oocytes retrieved. Multiple linear regression analyses indicated no significant effects of PCOS or continuous BMI on the number of mature oocytes fertilized per mature oocyte retrieved or inseminated. Similarly, multiple logistic regression analyses suggested no significant effect of PCOS and continuous BMI on the odds of pregnancy, miscarriage or live birth. Furthermore, categorical BMI did not influence process and outcome measures of IVF/ICSI treatment success. PCOS and continuous BMI appear to have significant and distinct effects on early stages but not on later stages of IVF/ICSI treatment.

R esearch suggests that teens require more than 9 hours of sleep per night in order to function optimally. Insufficient sleep in teens is common 2 and could eventuate in excessive sleepiness 3 and such onerous consequences as academic difficulties, behavioral abnormalities, 4,5 mood disorders and perhaps even increased risk of suicidal ideation. 6 A potential critical consequence of insufficient sleep in teens is drowsy driving. Fall-asleep crashes tend to be severe, and, of these, 55% have been found to occur in individuals who are 25 years or younger. 7 For the years 2007 and 2008, individuals aged 16-20 years had the highest injury rate from motor vehicle crashes. 8 While individuals aged 15 to 20 years represented only 9% of the U.S. population and 6% of licensed drivers for 2007, 19% of all fatalities in the United States were related to young-driver crashes. 9 Early high school start times could contribute to insufficient sleep in teenagers 10 and increased motor vehicle crashes. One study found start time to be the main determinant of wake times in adolescents. 11 A recent study revealed that a 30-min delay in high school start time was associated with 45 min of additional sleep on weekday nights and reduced sleepiness. 12 Thus, later high school start times could result in more sleep and better synchronicity with the circadian phase delay found in teens. 3 Unfortunately, the relationship of high school start times to crash rates has rarely been investigated. One recent study by Danner and Phillips did demonstrate that delaying high school start times reduced vehicle crashes in teens. In Lexington Kentucky, a 1-h delay in high school start times was associated with a 16.5% decline in teen crashes in the ensuing 2 years. 13 Adjacent and demographically similar cities in Southeastern Virginia, Virginia Beach and Chesapeake offer a propitious opportunity to compare further school start times and teen crashes. These adjoining cities have markedly different public high school start times. Virginia Beach begins public high school Study Objectives: Early high school start times may contribute to insufficient sleep leading to increased teen crash rate. Virginia Beach (VB) and Chesapeake are adjacent, demographically similar cities. VB high schools start 75-80 minutes earlier than Chesapeake's. We hypothesized that VB teens would manifest a higher crash rate than Chesapeake teens. Methods: The Virginia Department of Motor Vehicles (DMV) provided de-identified, aggregate 2008 and 2007 data for weekday crashes and crash times in VB and Chesapeake for drivers aged 16-18 years ("teens"), and provided 2008 and 2007 crash data for all drivers. Data allowed comparisons of VB versus Chesapeake crash rates for teens (overall and hour-by-hour), and teens versus all other ages. We compared AM and PM traffic congestion (peak hours) in the two cities.

The Z technique is an easy technique to learn. Physicians who learn this technique are able to retrieve the mid-coronal plane of the uterus faster and improve its image quality in volume sonography.