UK Efficacy and Mechanism Evaluation Programme and National Institutes of Health.

Normal pregnancies have been established in four women with tubal infertility by fertilization in vitro, embryo culture, and embryo transfer after stimulation of follicular growth with clomiphene citrate. In three of these women the time of oocyte maturation was controlled by human chorionic gonadotropin. This procedure for the control of ovulatory response has many advantages when compared with the previously successful method of using the natural ovulatory cycle.

Background and Aim Exclusive enteral nutrition (EEN) is progressively being used as a therapeutic option for adults with Crohn's Disease (CD); however, there is no standardized approach to delivering this therapy. The aim of this study is to develop an optimal care pathway for using EEN in adults with CD. This will create a standard of care that can be used as a benchmark practice and will provide direction for future research. Methods A working group of 12 multidisciplinary inflammatory bowel disease specialists across Australia and New Zealand was convened to develop a practical, clinically focused care pathway for using EEN in adults with active CD. Six key areas were identified as part of the care pathway: clinical indications, nutrition assessment, EEN protocol, monitoring, accessing formula, and food reintroduction. Current literature was identified via systematic review, and quality of evidence was graded. Consensus expert opinion was used where literature gaps were identified. Results An optimal care pathway for using EEN in adults with CD was developed with six key consensus statements on how to use EEN in adults with active CD. These key statements identify clinical indications for use, nutrition assessment, enteral prescription and duration of therapy, monitoring criteria, food reintroduction, and the role of partial EEN. An accompanying patient resource was also developed. Conclusion EEN is recommended as a treatment option to induce remission in adults with active CD. The consensus statements developed are practical and are based on best available evidence and expert opinion to assist in developing a standardized approach to delivering EEN therapy.

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Dry matter productivity under saline conditions was compared in 5 desiccation-tolerant "resurrection" grasses and one desiccation sensitive species, all in the genus Sporobolus. S. stapfianus was the most salt tolerant, requiring 215 mole NaCl m to reduce shoot dry matter increments to 50% of increments in plants not treated with salt. (This was comparable to published values for the salt tolerant grass Diplachne fusca.) S. lampranthus was salt sensitive, requiring 35 mol m for 50% control yields. S. festivus, S. aff. Fimbriatus, and the deisccation sensitive S.pyramidalis was moderately tolerant (150-170 mol m). The moderate salt resistance of S. aff. fimbriatus was attributed mainly to exclusion of NaCl by roots. Salt export through leaf surfaces was a minor factor. Half of the leaf mesophyll cells survived 50 min immersion in 200 mol NaCl m. Plants of S. aff. fimbriatus and S. pyramidalis tolerated a broad range of soil pH. Plants of 4 desiccation tolerant Sporobolus species survived air-dryness following 3 weeks pretreatment with salinities up to 200 mol m.

Scope The concept that dietary factors are key risk and preventive agents in the development of Crohn's disease (CD), while widely believed and supported by epidemiological evidence, has yet to lead to clear identification of those factors through clinical trials. The aims are to examine the strength of the epidemiological evidence of diet and its association with CD, examine how interpretation of mostly epidemiological data has shaped ideas for potential dietary therapies, and to explore other factors that have driven the design of dietary clinical trials in CD. Methods A literature search is performed in PubMed, Medline, EMBASE, and Google Scholar for prospective cohort studies and randomized clinical trials (RCTs) using search terms—“Crohn's disease,” “diet,” “risk,” “remission,” “treat,” “cohort,” “randomised.” Results Only four prospective cohort studies examine the relationship of diet and CD development, but these trials have been largely ignored by dietary RCTs in CD, which have used predominantly exclusion diets in small populations without objective endpoint assessment. Only one demonstrated clinical benefit to intestinal inflammation. Conclusion Investment in large multicenter dietary clinical trials that focus on dietary inclusions with objective endpoint assessment are needed to provide safe, sustainable dietary therapy to patients with CD.