INPUT ARTICLE: Article: If your doctor recommends a diagnostic test, it means they think you're at high risk for Down syndrome based on the results of screening test(s) combined with your age. However, although a prenatal diagnostic test can determine the presence of Down syndrome with certainty, they carry a higher risk to your health and that of your baby's because they are more invasive. As such, consult with your doctor about the pros and cons of such testing.  Invasive testing means that a needle or similar implement must be inserted into your abdomen and uterus to take a sample of fluid or tissue in order to analyze it. Diagnostic tests that can positively identify Down syndrome in pregnant women include: amniocentesis, chorionic villus sampling (CVS) and cordocentesis. However, keep in mind that these procedures do not come without risks. There is a risk of bleeding, infection, and harm to the fetus. An amniocentesis involves collecting a sample of amniotic fluid that surrounds your growing baby. A long needle is inserted into your uterus (through your lower abdomen) in order to withdraw fluid that contains some cells from your baby. The chromosomes of the cells are then analyzed, looking for trisomy 21 or other genetic disabilities.  An amniocentesis is usually performed during the second trimester, between weeks 14 to 22 of pregnancy.  The main risk of amniocentesis is a miscarriage and death of the baby, which increases if it's done before 15 weeks. The risk of a spontaneous termination (miscarriage) from amniocentesis is estimated at 1%.  Amniocentesis can also distinguish between the slightly different forms of Down syndrome: regular trisomy 21, translocation Down syndrome and mosaic Down syndrome. In a CVS procedure, cells are taken from a part of the placenta (which surrounds your baby within your uterus) called the chorionic villus and used to analyze the chromosomes for an abnormal number. This test also requires inserting a large needle into your abdomen / uterus. CVS is usually performed in the first trimester, between 9 to 11 weeks of pregnancy, although after the 10th week is considered less risky. This test be done sooner than amniocentesis, which is important if you plan to abort the baby if it has Down syndrome.   A CVS carries a slightly higher risk of miscarriage than a second trimester amniocentesis — perhaps slightly more than a 1% chance of miscarriage. A CVS can also distinguish between the slightly different genetic forms of Down syndrome. With cordocentesis, also called percutaneous umbilical blood sampling or PUBS, fetal blood is taken from a vein in the umbilical cord through the uterus with a long needle and examined for genetic mutations (extra chromosomes). This diagnostic test is performed later in the second trimester, between 18 to 22 weeks of gestation.  A cordocentesis is the most accurate diagnostic method for Down syndrome and can confirm the results from an amniocentesis or CVS procedure.  PUBS carries a much greater risk of miscarriage than amniocentesis or CVS, so your doctor should only recommend it if results from other diagnostic tests are unclear. If you didn't get any prenatal screening or diagnostic tests done prior to giving birth, then the initial diagnosis of Down syndrome is typically based on your baby's appearance. However, some babies may have the general appearance of Down syndrome, but not have the condition, so your doctor can order a test called chromosomal karyotyping.  A chromosomal karyotype requires a sample of your baby's blood to analyze for an extra 21st chromosome, which can be present in all or some cells. A significant reason for early screening and diagnostic tests is to give parents options before birthing, including terminating the pregnancy. If you believe you will be unable to care for your newborn with Down syndrome, ask your doctor about adoption options.

SUMMARY: Consult with your doctor. Get an amniocentesis done. Consider chorionic villus sampling (CVS). Be very cautious with cordocentesis. Diagnose your newborn.


INPUT ARTICLE: Article: Thick, dense breads like whole grains and sourdoughs can take longer cooking times. Fluffy, tender breads like challah and brioche can't take as much heat and need shorter cooking times. Choose any bread, like ciabatta, semolina bread, baguette, or rye. Cut the slice thickly if you have a loaf. Turn the burner on the stove to low and place 1/2 teaspoon of butter in the pan. Let the butter melt. Make sure to use real butter and not margarine. After the butter has melted, place the bread into the pan. Make sure the bread soaks up the butter. Place a lid over the pan and let the bread cook for 2-3 minutes.  After 2-3 minutes, flip the bread over. Make sure the other side of the bread soaks up some of the butter in the pan. Place the lid back on top. Let this side toast for 2-3 minutes.  An alternative is to toast the bread in a pan that has no butter in it. Just let the bread brown in the pan and then flip. Butter it after you remove it from the pan. When the bread has browned to your desired level of crisp, take the bread out of the pan. Do not add extra butter after taking it out of the pan.  This method of toasting bread cooks the butter into the bread, giving it a different flavor than if you add the butter after it is toasted. This method ensures there are no uneven chunks of butter on the toast, and helps the toast not to be soggy from too much buttering. Toasting the bread this way allows for a crisp outside but a fluffy, chewy inside.

SUMMARY:
Choose your bread. Heat the pan. Toast the bread in the pan. Remove from the pan.