[Effects of different growth factors on new bone formation: a systematic review]

Using different osteogenic growth factors, which is still under investigation, is a favorable method for bone regeneration. This systematic review is aimed at evaluating the effects of different growth factors and their carriers on osteogenesis. Electronic databases [Medline, EMBase and Cochrane] were searched by the authors for articles published from 1999 to April 2010. Clinical and animal studies evaluating bone formation by applying a specific growth factor and the related carrier were included in this investigation. Obtained data were organized in a table and evaluated through a qualitative analysis. Sixty-three studies most of which evaluated the effects of BMP-2 osteogenesis in different models were included in this study. Totally, twenty-five carriers were applied with different growth factors in the experiments. Among these carriers, poly lactic- co glycolic acid [PLGA], hydroxy apatite/tricalcium phosphate/absorbable collagen sponge [HA/TCP/ACS] and BioOss were the most frequently used carriers with the growth factors in bone regeneration studies. The current evidence, although not strong enough, confirms that BMP-2 has more favorable results in osteogenesis compared with other factors. The carrier scaffold, methods of measurement [histologic or radiographic], type of animal, defect diameter and the length of follow-up are the variables that should be matched before reaching definite results for the effect of growth factors in bone regeneration

Quintuplets pregnancy following clomiphene-induced ovulation

A quintuplets pregnancy following clomiphene-induced ovulation is presented as a matter of record. The importance of keeping in mind such a serious complication is emphasized in order to achieve early diagnosis and appropriate management. In pregnancies following clomiphene treatment, close supervision is imperative as soon as the pregnancy is evident. Department of Obstrics and Gynecology, Faculty of Medicine, University of Tehran Induction of ovulation is frequently used in the treatment of infertility. It is mainly carried out by the use of clomiphene citrate [CC], human menopausal gonadotropin, and human chorionic gonadotropin, either separately or in combination [1,5]. Ovarian enlargement and overstimulation are the most frequent side effects of clomiphene administration [3,4]. The true incidence of multiple pregnancy formation following clomiphene citrate therapy is not known.Further more, the manner in which clomiphene citrate is prescribed for the treatment of infertility is not yet standardized [5], A case report of quintuplets following clomiphene induced ovulation, diagnosed by ultrasound, and confirmed after delivery, is presented to illustrate these points. Medical rarities warrant publication not only as clinical curiosities, but also to serve as a warning to other physicians of possible dangers in particular modes of therapy. The following case presentation prompted discussion in two areas. First the indications for the use of clomiphene, and second, the formation of a quintuplets after clomiphene therapy