bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Wild-Type and ΔF508 Cystic Fibrosis Transmembrane Regulator in Human Respiratory Epithelia
Authors: Kreda Silvia M. , Mall Marcus , Mengos April , Rochelle Lori , Yankaskas James , Riordan John R. , Boucher Richard C.
Published: February 2005

Previous studies in native tissues have produced conflicting data on the localization and metabolic fate of WT and ΔF508 cystic fibrosis transmembrane regulator (CFTR) in the lung. Combining immunocytochemical and biochemical studies utilizing new high-affinity CFTR mAbs with ion transport assays, we examined both 1) the cell type and region specific expression of CFTR in normal airways and 2) the metabolic fate of ΔF508 CFTR and associated ERM proteins in the cystic fibrosis lung. Studies of lungs from a large number of normal subjects revealed that WT CFTR protein localized to the apical membrane of ciliated cells within the superficial epithelium and gland ducts. In contrast, other cell types in the superficial, gland acinar, and alveolar epithelia expressed little WT CFTR protein. No ΔF508 CFTR mature protein or function could be detected in airway specimens freshly excised from a large number of ΔF508 homozygous subjects, despite an intact ERM complex. In sum, our data demonstrate that WT CFTR is predominantly expressed in ciliated cells, and ΔF508 CFTR pathogenesis in native tissues, like heterologous cells, reflects loss of normal protein processing.
Genetic Predisposition to Latex Allergy
Authors: Brown Robert H. , Hamilton Robert G. , Mintz Margaret , Jedlicka Anne E. , Scott Alan L. , Kleeberger Steven R.
Published: February 2005

Background

Occupational exposure of healthcare workers to natural rubber latex has led to sensitization and potentially life-threatening anaphylaxis. Although environmental exposure to natural rubber latex products is necessary for sensitization, it is not sufficient. A number of genetic factors also seem to contribute to the latex sensitization; however, the multigenic nature of the allergic phenotype has made the identification of susceptibility genes difficult. The current study tests the hypothesis that known functional polymorphisms in genes encoding interleukin 4, interleukin 13, and interleukin 18 occur in a higher frequency in healthcare workers with natural rubber latex allergy.

Methods

Four hundred thirty-two healthcare workers with occupational exposure to natural rubber latex were screened using a clinical history questionnaire and latex-specific immunoglobulin E serology. Genomic DNA was extracted from peripheral blood lymphocytes and analyzed for single-nucleotide polymorphisms in candidate genes of interest. Data from cases and controls were analyzed by nominal logistic regression, with P < 0.05 considered significant.

Results

The latex allergy phenotype was significantly associated with promoter polymorphisms in IL13 -1055 (P = 0.02), IL18 -607 (P = 0.02), and IL18 -656 (P = 0.02) compared with nonatopic controls.

Conclusions

The significant association of IL13 and IL18 promoter polymorphisms with latex allergy suggests a potential location for genetic control in the induction of latex allergy in individuals and extends the understanding of the genetic basis for the induction of immediate-type hypersensitivity in healthcare workers occupationally exposed to natural rubber latex.
Genotyping the Butyrylcholinesterase in Patients with Prolonged Neuromuscular Block after Succinylcholine
Authors: Levano Soledad , Ginz Hans , Siegemund Martin , Filipovic Miodrag , Voronkov Evgueni , Urwyler Albert , Girard Thierry
Published: February 2005

Background

Succinylcholine remains the standard neuromuscular blocking drug for tracheal intubation in emergency situations. The short duration of action is due to its rapid hydrolytic degradation by butyrylcholinesterase (plasmacholinesterase). Multiple variants of this enzyme are known (A, F, S, H, J, K variants) with different effects on enzyme activity. This study was undertaken to evaluate the use of molecular genetic methods in patients with clinically prolonged neuromuscular block.

Methods

Nine patients with a neuromuscular block of 14 min to 5 h were selected. All four exons of the butyrylcholinesterase were amplified by polymerase chain reaction and analyzed by automated sequencing. Molecular genetic results were compared with clinical relaxation time and with biochemical test results (total butyrylcholinesterase activity, dibucaine and fluoride inhibition).

Results

Seven of nine patients were mutation carriers. Five of these had more than one mutation. The A and K variants were the most frequent variations. Three of four patients who were homozygous for the A variant were also carriers of the K allele. The authors identified one novel mutation (G1294T) introducing a stop codon at amino acid position 432. The duration of neuromuscular block was substantially different between patients with identical butyrylcholinesterase genotypes.

Conclusions

Variations in the genetic sequence of butyrylcholinesterase are frequent in patients with prolonged duration of action of succinylcholine. Direct sequencing of the whole butyrylcholinesterase gene is an appropriate method for genotyping and, accordingly, should be used in future clinical studies with drugs metabolized by this enzyme (e.g., succinylcholine, mivacurium).
Effect of α2B-Adrenoceptor Polymorphism on Peripheral Vasoconstriction in Healthy Volunteers
Authors: Talke Pekka , Stapelfeldt Claudia , Lobo Errol , Brown Ronald , Scheinin Mika , Snapir Amir
Published: February 2005

Background

Alpha-2B adrenoceptor is the vasoconstrictive subtype in the mouse. Human alpha2B-AR deletion (D) allele has been associated with loss of short-term agonist-promoted receptor desensitization, which may lead to increased vasoconstriction on alpha2 activation. The goal of this study was to test the hypothesis that alpha2B-adrenoceptor activation induces enhanced vasoconstriction in carriers of the DD genotype, compared with carriers of the insertion/insertion (II) genotype.

Methods

The authors administered increasing doses of dexmedetomidine (targeting plasma concentrations of 0.15, 0.3, 0.6, and 1.2 ng/ml) to 16 healthy young volunteers (8 carrying the alpha2B DD genotype, 8 carrying the II genotype) in whom sympatholytic effects of the drug were attenuated by general anesthesia. Measurements were made of finger blood volume (an indicator of vasoconstriction) by photoplethysmographic determination of light transmitted through a finger, finger blood flow by venous occlusion plethysmography, and hemodynamic variables.

Results

All concentration of dexmedetomidine increased light transmitted through the finger (vasoconstriction) and systolic blood pressure and decreased heart rate in both groups (P < 0.001 for all). Dexmedetomidine reduced finger arterial inflow only in the DD group (P < 0.001). Dexmedetomidine had no effect on finger venous outflow or venous capacitance. There were no significant differences between the II and DD groups in any of the variables.

Conclusions

The results of this study confirm the alpha2 agonist induced vasomotor and hemodynamic effects in peripheral vasculature. However, the results do not support the hypothesis that alpha2B-adrenoceptor polymorphism has an effect on peripheral vasoconstriction in humans.
Pharmacogenetic Determinants of Human Liver Microsomal Alfentanil Metabolism and the Role of Cytochrome P450 3A5
Authors: Klees Theresa Mariero , Sheffels Pamela , Thummel Kenneth E. , Kharasch Evan D.
Published: February 2005

Background

There is considerable unexplained interindividual variability in the clearance of alfentanil. Alfentanil undergoes extensive metabolism by cytochrome P4503A4 (CYP3A4). CYP3A5 is structurally similar to CYP3A4 and metabolizes most CYP3A4 substrates but is polymorphically expressed. Livers with the CYP3A5*1 allele contain higher amounts of the native CYP3A5 protein than livers homozygous for the mutant CYP3A5*3 allele. This investigation tested the hypothesis that alfentanil is a substrate for CYP3A5 and that CYP3A5 pharmacogenetic variability influences human liver alfentanil metabolism.

Methods

Alfentanil metabolism to noralfentanil and N-phenylpropionamide was determined in microsomes from two groups of human livers, characterized for CYP3A4 and CYP3A5 protein content: low CYP3A5 (2.0-5.2% of total CYP3A, n = 10) and high CYP3A5 (46-76% of total CYP3A, n = 10). Mean CYP3A4 content was the same in both groups. The effects of the CYP3A inhibitors troleandomycin and ketoconazole, the latter being more potent toward CYP3A4, on alfentanil metabolism were also determined.

Results

In the low versus high CYP3A5 livers, respectively, noralfentanil formation was 77 +/- 31 versus 255 +/- 170 pmol . min . mg, N-phenylpropionamide formation was 8.0 +/- 3.1 versus 20.5 +/- 14.0 pmol . min . mg, and the metabolite ratio was 9.5 +/- 0.4 versus 12.7 +/- 1.4 (P < 0.05 for all). There was a poor correlation between alfentanil metabolism and CYP3A4 content but an excellent correlation when CYP3A5 (i.e., total CYP3A content) was considered (r = 0.81, P < 0.0001). Troleandomycin inhibited alfentanil metabolism similarly in the low and high CYP3A5 livers; ketoconazole inhibition was less in the high CYP3A5 livers.

Conclusion

In microsomes from human livers expressing the CYP3A5*1 allele and containing higher amounts of CYP3A5 protein, compared with those with the CYP3A5*3 allele and little CYP3A5, there was greater alfentanil metabolism, metabolite ratios more closely resembled those for expressed CYP3A5, and inhibitors with differing CYP3A4 and CYP3A5 selectivities had effects resembling those for expressed CYP3A5. Therefore, alfentanil is metabolized by human liver microsomal CYP3A5 in addition to CYP3A4, and pharmacogenetic variability in CYP3A5 expression significantly influences human liver alfentanil metabolism in vitro. Further investigation is warranted to assess whether the CYP3A5 polymorphism is a factor in the interindividual variability of alfentanil metabolism and clearance in vivo.
Facilitation of Serotonergic Activity and Amnesia in Rats Caused by Intravenous Anesthetics
Authors: Semba Kazunori , Adachi Naoto , Arai Tatsuru
Published: February 2005

Background

Midazolam and propofol often provoke retrograde amnesia after recovery from anesthesia in humans. Because an increase in central serotonergic activity impairs learning and memory, the authors examined the relation between changes in the serotonergic activity caused by intravenous anesthetics and memory.

Methods

Changes in extracellular concentrations of monoamines and their metabolites were investigated in rat striatum by a microdialysis procedure, and the effects of intraperitoneal injections of midazolam (5 mg/kg), propofol (60 mg/kg), and pentobarbital (15 mg/kg) were then examined. To evaluate the behavioral alteration with these agents, the authors used a step-through passive avoidance test.

Results

Midazolam and propofol slightly increased the extracellular concentration of 5-hydroxytryptamine in the striatum, although pentobarbital did not produce any changes. Midazolam and propofol increased the extracellular concentration of 5-hydroxyindoleacetic acid, a metabolite of 5-hydroxytryptamine, with the peak values each 138% and 138% of that in saline-injected animals, respectively. However, pentobarbital decreased the 5-hydroxyindoleacetic acid concentration to 61% of that in the saline group. Administration of midazolam or propofol immediately after the completing the passive avoidance learning reduced step-through latencies after 24 h, although pentobarbital-injected animals maintained a consistent performance. The effects of midazolam and propofol on step-through latencies were completely antagonized by intracerebroventricular administration of spiroxatrine (5 microg), a 5-hydroxytryptamine 1A antagonist, 30 min before training.

Conclusions

Midazolam and propofol increased central serotonergic activity and provoked retrograde amnesia. Because amnesia was completely diminished by a 5-hydroxytryptamine antagonist, facilitation of the serotonergic system may be involved in retrograde amnesia caused by these agents.
Comparison of the Different Approaches to Saphenous Nerve Block
Authors: Benzon Honorio T. , Sharma Sanjay , Calimaran Arthur
Published: February 2005

Background

The authors compared the efficacy of the different approaches to saphenous nerve block.

Methods

The following approaches to saphenous nerve block were compared in 10 volunteers: perifemoral, transsartorial, block at the medial femoral condyle, below-the-knee field block, and blockade at the level of the medial malleolus. Each volunteer underwent all five blocks, and the interval between blocks was 3-7 days. The sequence of injection was randomized by Latin square design. Sensory blockade at the medial aspects of the leg and foot and the strength of the anterior thigh muscles were noted.

Results

The transsartorial, perifemoral, and below-the-knee field block approaches were more effective than block at the medial femoral condyle in providing sensory anesthesia to the medial aspect of the leg. The transsartorial approach was more effective than block at the medial femoral condyle and below-the-knee field block in providing sensory anesthesia to the medial aspect of the foot. Compared with the perifemoral approach, the transsartorial approach did not cause weakness of the hip flexors and the knee extensors. In volunteers with partial numbness in the medial aspect of the foot, supplemental block of the medial dorsal cutaneous branch of the superficial peroneal nerve resulted in complete sensory blockade.

Conclusions

Sensory blockade in the medial aspects of the leg and foot is best achieved with the transsartorial approach. In some subjects, supplementary block of the medial dorsal cutaneous branch of the superficial peroneal nerve may have to be performed to assure complete numbness of the medial aspect of the foot.
Pharmacogenetics of Anesthetic and Analgesic Agents
Authors: Palmer Stephen N. , Giesecke N Martin , Body Simon C. , Shernan Stanton K. , Fox Amanda A. , Collard Charles D. , Warltier David C.
Published: February 2005

Predicting a patient's response to a particular drug has long been a goal of clinicians. Rapid advances in molecular biology have enabled researchers to identify associations between an individual's genetic profile and drug response. Pharmacogenetics is the study of the molecular mechanisms that underlie individual differences in drug metabolism, efficacy, and side effects. The pharmacogenetics of commonly used anesthetic and analgesic agents are reviewed.
Actinobacillus actinomycetemcomitans induces apoptosis in human monocytic THP-1 cells
Authors: Kato Satsuki , Sugimura Norihiko , Nakashima Keisuke , Nishihara Tatsuji , Kowashi Yusuke
Published: February 2005

It has previously been reported that the murine macrophage cell line J774.1 and the human oral epithelial cell line KB undergo apoptosis as a result ofActinobacillus actinomycetemcomitansinfection. Recent studies have demonstrated that apoptosis regulation is modulated by multiple phosphorylation of several different protein kinases, including the major subtypes of the mitogen-activated protein kinase (MAPK) family. The MAPK family promotes cell survival and/or proliferation in response to growth factor stimulation, or apoptosis in response to various stress stimuli. The primary objective of the present investigation was to clarify whether human immune cells undergo apoptosis followingA. actinomycetemcomitansinfection and, if so, to establish the involvement of the MAPK family. Human monocytic THP-1 cells were infected withA. actinomycetemcomitansin microtubes. Lactate dehydrogenase release into the culture supernatant and DNA fragmentation in the cells were monitored. DNA fragmentation was also identified by agarose gel electrophoresis. Cell death followingA. actinomycetemcomitansinfection occurred by apoptosis, shown by an increase in the proportion of fragmented DNA and the typical ladder pattern of DNA fragmentation indicative of apoptosis. Furthermore, p38 MAPK activity and tumour necrosis factor alpha (TNF-α) levels increased followingA. actinomycetemcomitansinfection. In contrast, cell death and TNF-α levels in infected cells decreased upon addition of a p38 inhibitor or an anti-TNF-α antibody. However, exogenous TNF-α could not induce apoptosis in uninfected THP-1 cells. Interestingly, p38 MAPK activity diminished in the presence of anti-TNF-α antibody. These findings indicated thatA. actinomycetemcomitansinfection induces apoptosis in THP-1 cells and that p38 MAPK activity is directly involved in apoptosis. TNF-α may play an indirect role in apoptosis via enhanced p38 MAPK activity.A. actinomycetemcomitans-induced apoptosis of human immune cells may be important in terms of initiation and progression of periodontal diseases.
Pseudogene accumulation might promote the adaptive microevolution of Yersinia pestis
Authors: Tong Zongzhong , Zhou Dongsheng , Song Yajun , Zhang Ling , Pei Decui , Han Yanping , Pang Xin , Li Min , Cui Baizhong , Wang Jin , Guo Zhaobiao , Qi Zhizhen , Jin Lixia , Zhai Junhui , Du Zongmin , Wang Jun , Wang Xiaoyi , Yu Jun , Wang Jian , Huang Peitang , Yang Huanming , Yang Ruifu
Published: February 2005

Plague is a natural focus-based disease, and for better understanding of this disease it is crucial to determine the molecular mechanisms of its pathogen, Yersinia pestis, for adapting to different foci. Gene inactivation, loss and acquisition are the main mechanisms that contribute to a pathogen's fitness. Determination of the whole-genome sequences of three Y. pestis strains, CO92, KIM and 91001, provided a good opportunity to probe into its genome in minute detail. Many genetic variations were found between the three strains. The present work focused on adaptive microevolutionary analysis of Y. pestis from different natural plague foci in China based on pseudogene profiles. Twenty-four mutations that led to inactivation in the corresponding genes were analysed, and a PCR-based screening method was employed to investigate the distribution of these mutations among Y. pestis isolates from different foci and also among seven strains of Yersinia pseudotuberculosis. It was found that Y. pestis isolates from the same focus had identical mutation profiles, and 260 isolates of Y. pestis were divided into eight genotypes, while Y. pseudotuberculosis harboured wild-type alleles for all the mutations. The isolates of three known biovars were grouped into distinct branches in the phylogenetic tree, which supports the proposition that biovars mediaevalis and orientalis directly arose from biovar antiqua individually. The constructed phylogenetic tree suggests that the isolates from focus B should be the oldest lineage of Y. pestis in China except for isolates from foci L and M, which might be a special lineage of Y. pestis and originated differently to the others.
Genotypic variation and antifungal susceptibilities of Candida pelliculosa clinical isolates
Authors: Barchiesi F , Tortorano A M , Di Francesco L Falconi , Rigoni A , Giacometti A , Spreghini E , Scalise G , Viviani M A
Published: February 2005

At the Istituto Ricovero Cura Carattere Scientifico, Ospedale Maggiore di Milano, Italy,Candida pelliculosaaccounted for 3.3 and 4.4 % of allCandidaspecies other thanCandida albicanscollected during 1996 and 1998, respectively. Genetic variability was investigated by electrophoretic karyotyping and inter-repeat PCR, and the susceptibility to five antifungal agents of 46 strains isolated from 37 patients during these 2 years was determined. Combination of the two typing methods yielded 14 different DNA types. Although the majority of DNA types were randomly distributed among different units, one DNA type was significantly more common in patients hospitalized in a given unit compared with those from other wards (P= 0.034), whereas another DNA type was more frequently isolated in patients hospitalized during 1996 than in those hospitalized during 1998 (P= 0.002). Fluconazole, itraconazole and posaconazole MIC90values were 16, 1 and 4 μg ml−1, respectively. All isolates but three were susceptiblein vitroto flucytosine. All isolates were susceptiblein vitroto amphotericin B. These data suggest that there are possible relationships among strains ofC. pelliculosa, wards and time of isolation. Amphotericin B seems to be the optimal drug therapy in infections due to this yeast species.
Monochrome LightCycler PCR assay for detection and quantification of five common species of Candida and Aspergillus
Authors: Bu Rong , Sathiapalan Rajeev K , Ibrahim Muna M , Al-Mohsen Ibrahim , Almodavar Edna , Gutierrez Marina I , Bhatia Kishor
Published: February 2005

Invasive fungal pathogens, especially in immunocompromised hosts, can result in life-threatening infections. Current laboratory/radiological methods for fungal identification are time-consuming and lack sensitivity and specificity. A monochrome, multiplex, real-time PCR assay for the identification and quantification of Candida albicans, Candida krusei, Candida tropicalis, Aspergillus flavus and Aspergillus fumigatus is described here. Detection of each of these fungi was specific and demonstrated 100 % concordance with biochemical/culture identification in all 60 isolates tested. Samples from 16 febrile neutropenic patients with haematological malignancies were also analysed and the utility of the assay in clinical samples was reconfirmed without false-negative results. The sensitivity of this assay was 0.1 pg fungal genomic DNA, corresponding to three cells, for C. albicans, C. krusei, C. tropicalis and A. flavus, and 0.01 pg fungal genomic DNA, i.e. less than one cell, for A. fumigatus. The analysis allows a low-cost, simple, rapid and sensitive alternative for clinical identification and quantification of these five common fungal species.
Sample type is crucial to the diagnosis of Mycoplasma pneumoniae pneumonia by PCR
Authors: Räty Riitta , Rönkkö Esa , Kleemola Marjaana
Published: February 2005

Sensitive and specific methods for rapid laboratory diagnosis of Mycoplasma pneumoniae were not available until nucleic acid amplification methods were developed. The choice of sample type and method of sampling are crucial to optimal diagnostic efficacy. Three types of respiratory samples from 32 young military conscripts with pneumonia were collected during an outbreak of M. pneumoniae infection. Sputum, nasopharyngeal aspirate and throat swab specimens were tested by 16S rRNA gene-based PCR with liquid-phase probe hybridization, and the results were compared with serology. The PCR result was positive for 22 (69 %) of the sputa, 16 (50 %) of the aspirates and 12 (37.5 %) of the swabs. Serology with increasing or high titres supported the positive findings in all instances. Sputum, when available, is clearly the best sample type for young adults with pneumonia.
Normal labor associated with changes in uterine heparan sulfate proteoglycan expression and localization
Authors: Hjelm Cluff Ann , Malmström Anders , Tingåker Berith , David Guido , Ekman‐Ordeberg Gunvor
Published: February 2005

Hypothesis:  Proteoglycans are well‐known modulators of intercellular communication and signaling. Remodeling of the proteoglycans in the human uterus occurs throughout pregnancy, and during labor. We therefore hypothesize that heparan sulfate proteoglycans (HSPGs) play an important role in establishing normal labor. In this study HSPGs were characterized and localized in human uterine tissue.

Methods:  Uterine biopsies were obtained from four nonpregnant women, four women during elective cesarean section and four during emergency cesarean section. The biopsies were extracted using 4 m guanidinium hydrochloride (GuHCL). HSPGs were then purified by repeated ion‐exchange chromatography on dehydroepiandrosterone (DEAE)‐cellulose after digestion with chondroitinase ABC and finally precipitated with Alcian blue. HSPGs were identified by agarose gel electrophoresis and Western blotting. Controlled degradation of the heparan sulfate (HS) side‐chains was performed using heparitinase or deglycosylation with trifluoromethanesulfonic acid (TFMS). The resulting core proteins were separated by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS–PAGE) and visualized by Coomassie staining. HSPGs were localized in uterine tissue by immunohistochemistry.

Results:  SDS–PAGE after deglycosylation indicated the presence of multiple distinct core proteins tentatively identified as syndecans 1–4 and glypican 1. Western blots confirmed the presence of these proteoglycans and also perlecan. Immunohistochemistry revealed that the HSPGs were localized mainly in the smooth muscle with few in the extracellular matrix (ECM). Syndecan 3, the dominant proteoglycan, showed the most pronounced changes during pregnancy and labor.

Conclusion:  For the first time several heparan sulfate proteoglycans have been identified and localized in the human uterus and shown to vary in expression during pregnancy and labor. Syndecan 3 had the most outstanding features in this respect.
Reduction in hospitalized women with pelvic inflammatory disease in Oslo over the past decade
Authors: Sørbye Ingvil Krarup , Jerve Fridtjof , Staff Anne Cathrine
Published: February 2005

Background.  A tuboovarian abscess (TOA) is a common complication of pelvic inflammatory disease (PID), occurring world‐wide in 15–30% of women with PID. The aim of the study was to identify changes during the last 10 years in the number of women hospitalized with PID in Oslo, as well as a change regarding the frequencies of the subdiagnoses salpingitis and tuboovarian abscess.

Methods.  We performed a review of computerized diagnosis lists and manual check of the medical records of women hospitalized with PID in Oslo. The years 1990–92 and 2000–02 were included, resulting in information from two time periods 10 years apart. Cases were registered as salpingitis, oophoritis or tuboovarian abscess. Medical and demographic variables from the medical records of women diagnosed during 4 out of the 6 years were described in detail.

Results.  We identified 523 women with the diagnosis of PID hospitalized during 1990–92 and 2000–02. There was a 35% reduction in hospitalized cases of salpingitis over the period of 10 years, but the number of cases of tuboovarian abscesses among women admitted for PID remained unchanged from 1990–92 to 2000‐02. We found low frequencies of Chlamydia trachomatis and Neisseria gonorrhoea infections, although documented bacteriological sampling was insufficient.

Conclusions.  Fewer patients were hospitalized in Oslo for PID during the time period of 2000–02 compared with 10 years earlier, but a higher percentage of patients had developed TOA compared with the first time period (43% compared with 26%, p = 0.013), indicating a changing clinical panorama of PID.
Iron prophylaxis during pregnancy – How much iron is needed? A randomized dose– response study of 20–80 mg ferrous iron daily in pregnant women
Authors: Milman Nils , Bergholt Thomas , Eriksen Lisbeth , Byg Keld‐Erik , Graudal Niels , Pedersen Palle , Hertz Jens
Published: February 2005

Objective.  To determine the lowest dose of iron preventative of iron deficiency and iron deficiency anemia in pregnancy.

Methods.  A randomized, double‐blind intention‐to‐treat study comprising 427 healthy pregnant women allocated into four groups taking ferrous iron (as fumarate) in doses of 20 mg (n = 105), 40 mg (n = 108), 60 mg (n = 106), and 80 mg (n = 108) from 18 weeks of gestation. Iron status markers [hemoglobin (Hb), serum ferritin, and serum soluble transferrin receptor (sTfR)] were measured at 18 weeks (inclusion), 32 weeks, and 39 weeks of gestation and 8 weeks postpartum. Side effects of iron supplements were recorded. Iron deficiency was defined as serum ferritin <13 µg/l and iron deficiency anemia as serum ferritin <13 µg/l and Hb <5th percentile in iron replete pregnant women.

Results.  There were no significant differences between variables in the four groups at inclusion. At 32 and 39 weeks of gestation, group 20 mg had significantly lower median serum ferritin (13 and 16 µg/l) than group 40 mg (17 and 21 µg/l), group 60 mg (18 and 23 µg/l), and group 80 mg (21 and 24 µg/l) (p < 0.0001). At 32 and 39 weeks of gestation, group 20 mg had a significantly higher prevalence of iron deficiency (50 and 29%) than group 40 mg (26 and 11%), group 60 mg (17 and 10%), and group 80 mg (13 and 9%) (p < 0.001). The prevalence of iron deficiency anemia at 39 weeks of gestation was significantly higher in group 20 mg (10%) than in group 40 mg (4.5%), group 60 mg (0%), and group 80 mg (1.5%) (p = 0.02). At 32 weeks of gestation, mean Hb in group 20 mg was lower than in group 80 mg (p = 0.06). There were no significant differences in iron status (ferritin, sTfR, and Hb) between group 40, 60, and 80 mg. Postpartum, group 20 mg had significantly lower median serum ferritin than group 40, 60, and 80 mg (p < 0.01). The prevalence of postpartum iron deficiency anemia was low and similar in the four groups. The frequency of gastrointestinal symptoms was not significantly different in the four iron supplement groups and thus not related to the iron dose.

Conclusion.  In Danish women, a supplement of 40 mg ferrous iron/day from 18 weeks of gestation appears adequate to prevent iron deficiency in 90% of the women and iron deficiency anemia in at least 95% of the women during pregnancy and postpartum.
Effect of vaginal distension on anorectal function: identification of the vagino‐anorectal reflex
Authors: Shafik Ahmed , Shafik Ismail , El‐Sibai Olfat
Published: February 2005

Background.  Sexual stimulation produces not only reflex changes in the female external and internal reproductive organs but also extragenital reactions. A mention of the response of the anal sphincters and the rectum to penile thrusting could not be traced in the literature. We investigated the hypothesis that the anal sphincters and the rectum respond to penile thrusting in a way that prevents gas and fecal leakage during sexual intercourse.

Methods.  The response of the external anal sphincter (EAS) and the internal anal sphincter (IAS) and the rectum to vaginal balloon (condom) distension was recorded in 23 healthy women (age: 33·7 ± 7·3 years). The vaginal condom was inflated with air in increments of 50–300 ml, and the electromyographic (EMG) activity of the EAS and the IAS, as well as rectal pressure, was recorded. The test was repeated after separate anesthetization of the vagina, the rectum, the EAS and the IAS and after the use of normal saline instead of lidocaine.

Results.  Vaginal distension reduced the rectal pressure in the ratio of expansion of the vaginal volume up to a certain volume, beyond which the rectal pressure ceased to decline when more distending volume was added. Similarly, the internal sphincter EMG activity increased progressively on incremental vaginal distension increase until the 150‐ml distension was reached after which more vaginal distension caused no further increase of the EMG activity; external sphincter EMG activity showed no response. Vaginal distension, while the vagina, the rectum, the EAS, and the IAS had been separately anesthetized, produced no significant change, but saline did.

Conclusions.  Vaginal balloon distension appears to effect rectal wall relaxation and increase of the internal sphincter tone. This seems to provide a mechanism to avoid rectal contents leakage during coitus. Rectal and internal sphincter response to vaginal distension is suggested to be mediated through a reflex we term ‘vagino‐anorectal reflex’, which seems to be evoked by vaginal distension during penile thrusting. The reflex may prove of diagnostic significance in sexual disorders; further studies are needed in order to investigate this point.
Autologous blood transfusion in patients with placenta previa
Authors: Yamada Takashi , Mori Hiroshi , Ueki Minoru
Published: February 2005

Background.  Several studies have shown that autologous blood storage during pregnancy is relatively safe for mother and fetus. However, the need for reappraisal of autologous blood transfusion in obstetric patients has been proposed.

Methods.  We retrospectively reviewed the cases of placenta previa and low‐lying placenta among pregnancies at our hospital during an 18‐year period, 1985–2002. The utility of autologous blood transfusion program, which started in 1994 for those with placental positional disorders, was evaluated.

Results.  Of the pregnancies reviewed, there were 158 cases (1.9%) of placenta previa or low‐lying placenta. The number of patients transfused with homologous blood decreased from 27.6% (21/76) in the period before implementation of the autologous blood transfusion program to 8.5% (7/82) after its implementation in 1994. In the latter time period, 39.0% (32/82) of patients with placenta previa and low‐lying placenta were phlebotomized and had blood stored. Of those, 71.9% (23/32) were reinfused where one patient (3.1%) needed homologous blood as well. The volume of collected blood per phlebotomy was 367 ± 65 ml, the total volume of collected blood per patient was 803 ± 350 ml, and the total of estimated blood loss per patient was 1326 ± 873 ml. The volume of reinfused blood per patient was 578 ± 326 ml.

Conclusions.  The program of autologous blood collection and transfusion in patients with placenta previa resulted in a decrease in homologous blood transfusion. In our program, we recommend starting blood collection and storage at 32 weeks' gestation and phlebotomize 400 ml per week to reach a volume of stored blood of 1200–1500 ml.
The Dark Side of the Protestant Ethic: A Comparative Analysis of Welfare Reform
Authors: Hudson Kenneth , Coukos Andrea
Published: February 2005

This article examines the impact of the Protestant Ethic and the Spirit of Capitalism on the recent welfare reform movement and the 19th-century campaign to abolish outdoor relief. Contemporary advocates of welfare reform adopted the 19th-century model of charity organization and reform as their exemplar. The welfare reform movement focused on the morals of the poor and “welfare dependence,” while the 19th-century movement attempted to eliminate the distribution of aid outside the poorhouse and to discourage “indiscriminate almsgiving”“ on the part of individuals. We argue that the Protestant ethos represents a uniquely Anglo-American variety of Calvinist Puritanism. We also show that while this ethos is a fairly constant component of American culture it has under certain conditions produced severe retrenchments in aid to the poor that is welfare reform and the abolition of outdoor relief. These conditions include the presence of a tight labor market and political mobilization by advocates of reform. Drawing on Ragin's (1987) model of conjunctural causation, we argue that both conditions must be met before such reform movements are likely to occur. We also employ the comparative method to show why alternative explanations based on economic and demographic factors are inadequate to explain the events in question.
From Virtual Public Spheres to Global Justice: A Critical Theory of Internetworked Social Movements
Authors: Langman Lauren
Published: February 2005

From the early 1990s when the EZLN (the Zapatistas), led by Subcommandte Marcos, first made use of the Internet to the late 1990s with the defeat of the Multilateral Agreement on Trade and Investment and the anti-WTO protests in Seattle, Quebec, and Genoa, it became evident that new, qualitatively different kinds of social protest movements were emergent. These new movements seemed diffuse and unstructured, yet at the same time, they forged unlikely coalitions of labor, environmentalists, feminists, peace, and global social justice activists collectively critical of the adversities of neoliberal globalization and its associated militarism. Moreover, the rapid emergence and worldwide proliferation of these movements, organized and coordinated through the Internet, raised a number of questions that require rethinking social movement theory. Specifically, the electronic networks that made contemporary globalization possible also led to the emergence of “virtual public spheres” and, in turn, “Internetworked Social Movements.” Social movement theory has typically focused on local structures, leadership, recruitment, political opportunities, and strategies from framing issues to orchestrating protests. While this tradition still offers valuable insights, we need to examine unique aspects of globalization that prompt such mobilizations, as well as their democratic methods of participatory organization and clever use of electronic media. Moreover, their emancipatory interests become obscured by the “objective” methods of social science whose “neutrality” belies a tacit assent to the status quo. It will be argued that the Frankfurt School of Critical Theory offers a multi-level, multi-disciplinary approach that considers the role of literacy and media in fostering modernist bourgeois movements as well as anti-modernist fascist movements. This theoretical tradition offers a contemporary framework in which legitimacy crises are discussed and participants arrive at consensual truth claims; in this process, new forms of empowered, activist identities are fostered and negotiated that impel cyberactivism.
Postmodernism and Sociology: From the Epistemological to the Empirical
Authors: Mirchandani Rekha
Published: February 2005

This article investigates the place of postmodernism in sociology today by making a distinction between its epistemological and empirical forms. During the 1980s and early 1990s, sociologists exposited, appropriated, and normalized an epistemological postmodernism that thematizes the tentative, reflective, and possibly shifting nature of knowledge. More recently, however, sociologists have recognized the potential of a postmodern theory that turns its attention to empirical concerns. Empirical postmodernists challenge classical modern concepts to develop research programs based on new concepts like time-space reorganization, risk society, consumer capitalism, and postmodern ethics. But they do so with an appreciation for the uncertainty of the social world, ourselves, our concepts, and our commitment to our concepts that results from the encounter with postmodern epistemology. Ultimately, this article suggests that understanding postmodernism as a combination of these two moments can lead to a sociology whose epistemological modesty and empirical sensitivity encourage a deeper and broader approach to the contemporary social world.
The role of parental presence in the context of children's medical procedures: a systematic review
Authors: Piira T. , Sugiura T. , Champion G. D. , Donnelly N. , Cole A. S. J.
Published: February 2005

Background  There are conflicting views and practices regarding whether or not parents should be present at the time of their child's medical procedure. A systematic review was conducted to assess the effects of parental presence in the paediatric treatment room on child, parent and health professional outcomes and to synthesize this body of literature.

Methods  Based on a comprehensive literature search, studies investigating parental presence in the paediatric treatment room were included in the review if they had a concurrent control group (i.e. a parent‐absent group).

Results  A total of 28 studies met inclusion criteria, which included 1256 children with a parent present and 1025 children without a parent present. There were mixed findings regarding the effect of parental presence on measures of child distress and affect, however, studies of lower levels of evidence were more likely to report significant results. Parents who were present during their child's medical intervention were either better off or no different from parents who were absent with regard to their levels of distress and satisfaction. There was no evidence of increased technical complications nor elevated staff anxiety for health professionals attending to children with a parent present as compared to attending to children without their parents.

Discussion  Although parental presence may not have a clear, direct influence on child distress and behavioural outcomes, there are potential advantages for parents. It seems appropriate that clinicians provide parents with the opportunity to be present during their child's painful procedure.
Quality of child health services in primary health care facilities in south‐east Nigeria
Authors: Ehiri J. E. , Oyo‐Ita A. E. , Anyanwu E. C. , Meremikwu M. M. , Ikpeme M. B.
Published: February 2005

Background To assess the quality of child health services in primary health care (PHC) facilities in Calabar, south‐east Nigeria.

Design Cross‐sectional, descriptive design.

Methods Key informant interviews, structured observation, self‐administered questionnaire and focus group discussion.

Setting Calabar, south‐east Nigeria.

Participants All 10 PHC facilities in Calabar, 252 PHC workers serving in the facilities, and 76 mothers whose children received care in the facilities.

Outcome measures Adequacy of structure (equipment and personnel); process (diagnosis, training and knowledge, use of national case‐management algorithm, and supervision), and output (clients’ satisfaction).

Main results PHC facilities were adequately equipped to the extent of providing immunization services and management of diarrhoea but not for other aspects of care expected of a PHC centre, including management of acute respiratory infections (ARI), a common problem in children in the region. Supply of essential drugs was inadequate in all centres and facilities for emergency care were lacking. Many of the health care workers (68.3%) had adequate training in immunization, and their knowledge scores on immunization issues (62%) was higher than in other aspect of PHC. Use of the national case management algorithm was low among PHC workers. Results of the focus group discussions with mothers showed that a few perceived quality of care to be poor. The main concerns were long waiting time, lack of essential drugs, and attitude of the health workers.

Conclusions Inadequacy in the quality of child health services in PHC facilities is a product of failures in a range of quality measures – structural (lack of equipment and essential drugs), process failings (non‐use of the national case management algorithm and lack of a protocol of systematic supervision of health workers). Efforts to improve the quality of child health services provided by PHC workers in the study setting and similar locales in less developed countries should focus not only on resource‐intensive structural improvements, but also on cheap, cost‐effective measures that address actual delivery of services (process), especially the proper use of national guidelines for case management, and meaningful supervision.
Iron deficiency in children with attention‐deficit/hyperactivity disorder
Authors: Reading Richard
Published: February 2005

.
 
Konofal E,
Lecendreux M,
Arnulf I &
Mouren M‐C.
(
2004
)

,
158
,
1113
–
1115
.

Background  Iron deficiency causes abnormal dopaminergic neurotransmission and may contribute to the physiopathology of attention‐deficit/hyperactivity disorder (ADHD).

Objective  To evaluate iron deficiency in children with ADHD vs. iron deficiency in an age‐ and sex‐matched control group.

Design  Controlled group comparison study.

Setting  Child and Adolescent Psychopathology Department in European Pediatric Hospital, Paris, France.

Patients  Fifty‐three  children  with  ADHD  aged 4–14 years (mean ± SD: 9.2 ± 2.2 years) and 27 controls (mean ± SD: 9.5 ± 2.8 years).

Main outcome measures  Serum ferritin levels evaluating iron stores and Conners’ Parent Rating Scale scores measuring severity of ADHD symptoms have been obtained.

Results  The mean serum ferritin levels were lower in the children with ADHD (mean ± SD: 23 ± 13 ng/mL) than in the controls (mean ± SD: 44 ± 22 ng/mL; P < 0.001). Serum ferritin levels were abnormal (<30 ng/mL) in 84% of children with ADHD and 18% of controls (P < 0.001). In addition, low serum ferritin levels were correlated with more severe general ADHD symptoms measured with Conners’ Parent Rating Scale (Pearson correlation coefficient: r = −0.34; P < 0.02) and greater cognitive deficits (r = −0.38; P < 0.01).

Conclusions  These results suggest that low iron stores contribute to ADHD and that ADHD children may benefit from iron supplementation.
A molecular approach to detect hybridisation between crucian carp (Carassius carassius) and non‐indigenous carp species (Carassiusspp. andCyprinus carpio)
Authors: HÄNFLING B. , BOLTON P. , HARLEY M. , CARVALHO G. R.
Published: February 2005

1. Releases of non‐native fish into the wild is an increasing problem posing considerable ecological and genetic threats through direct competition and hybridisation.

2. We employed six microsatellite markers to identify first generation hybrids and backcrosses between native crucian carp (Carassius carassius) and introduced goldfish (C. auratus) and common carp (Cyprinus carpio) in the U.K. We also investigated the genetic characteristics of the taxonomically controversial gibel carp (Carassiusspp.) from sites across Europe.

3. Natural hybridisation between goldfish and crucian carp occurs frequently, although hybrids between all other species pairs were observed. Only 62% of British crucian carp populations (n = 21) consisted exclusively of pure crucian carp. In some populations hybrids were so frequent, that no pure crucian carp were caught, indicating a high competitive ability of hybrids.

4. Most hybrids belonged to the F1 generation but backcrossing was evident at a low frequency in goldfish × crucian carp hybrids and goldfish × common carp hybrids. Furthermore, some local populations had high frequencies of backcrosses, raising the opportunity for introgression.

5. Gibel carp from Germany and Italy belonged to two triploid clonal lineages that were genetically closely related to goldfish, whereas all individuals identified from British populations proved to be crucian carp × goldfish hybrids.

6. Our study suggests that the release of closely related exotic cyprinids not only poses a threat to the genetic integrity and associated local adaptations of native species, but may also contribute to shifts in community structure through competitive interactions.
The importance of bacterivorous protists in the decomposition of stream leaf litter
Authors: RIBBLETT SUZANNA G. , PALMER MARGARET A. , WAYNE COATS D.
Published: February 2005

1. Allochthonous organic matter, in the form of senesced leaves, is a major source of carbon supporting detrital food webs. While studies have documented the role of bacteria and fungi in the decomposition of leaf litter, little information is available regarding the role of protists in the decomposition process.

2. We tested the hypothesis that the presence of stream‐dwelling bacterivorous protists leads to an increased rate of leaf decomposition through grazing pressure on bacteria. We isolated live protists from decomposing leaves collected in a stream in Northern Virginia, U.S.A. (Goose Creek) and established laboratory cultures of common bacterivorous protists.

3. Recently senesced leaves from the field were used in laboratory microcosm experiments to determine if the rate of litter decomposition differed between four treatments: bacteria only, bacteria + flagellates, bacteria + flagellates + ciliates, autoclaved stream water (control). We determined the dry weight of leaf remaining, bacterial abundance, flagellate abundance and ciliate abundance for each replicate on days 0, 7, 14, 30, 60 and 120.

4. The rate of leaf decomposition was significantly higher in treatments with protists than without and bacterial abundance declined in protist treatments compared with bacteria only treatment. Weight loss in the presence of flagellates was three to four times higher when protists were present compared with treatments with bacteria alone. These results provide experimental evidence that protists could play a significant role in the detrital processes of streams.