bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast‐feeding‐associated hypernatremia: Retrospective analysis of 169 term newborns
Authors: Unal Sevim , Arhan Ebru , Kara Nazli , Uncu Nermin , Aliefendioğlu Didem
Published: February 2008

Background: The aim of the present paper was to define the incidence, complications, morbidity and mortality of hypernatremic dehydration due to inadequate breast‐feeding in a neonatal intensive care unit.

Methods: A retrospective study was carried out between 2002 and 2005, to identify the term breast‐fed neonates with serum sodium level ≥150 mEq/L at the Ministry of Health Ankara Diskapi Children’s and Research Hospital.

Results: The incidence of hypernatremic dehydration secondary to inadequate breast‐feeding was 4.1%, occurring in 169 term infants among 4136 hospitalized term neonates with the following characteristics: mean gestational age, 39.1 weeks (37–42 weeks); birthweight, 3352 g (2200–4500 g); mother’s age, 26.1 years (17–38 years); weight loss, 15.9% (5.4–32.7%); proportion of spontaneous vaginal deliveries, 75.7%; and proportion of first‐time mothers, 74.6%. Major presenting symptoms were neonatal jaundice (47.3%) and poor infant suck (29.6%). The median sodium; blood urea nitrogen (BUN); and creatinine levels on admission were 155 mmol/L (150–194 mmol/L), 35 mg/dL (7–253 mg/dL), and 0.9 mg/dL (0.2–10 mg/dL), respectively. Major complications were as follows: acute renal failure, 82.8%; elevated liver enzymes, 20.7%; disseminated intravascular coagulation, 6.5%; brain edema, 5.2%; intracranial hemorrhage, 3.6%; cavernous sinus thrombosis, 1.2%; and bilateral iliac artery thrombosis, 0.6%. Ten patients (5.9%) developed seizure within the first 24 h of rehydration therapy with a mean sodium decrease of 11.9 mmol/L per day (4–19 mmol/L per day). Two patients (1.2%) died. There were positive correlation between weight loss and serum sodium, BUN, bilirubin levels (P < 0.01); there was no correlation between weight loss and mothers’ age, education level, delivery route, or first‐born status (P > 0.05).

Conclusions: Hypernatremic dehydration in neonates due to inadequate breast‐feeding is a serious, potentially devastating and life‐threatening disorder, and can damage the central nervous system. Follow up of infants for adequate breast‐feeding is important. Pediatricians must maintain a high level of suspicion, especially in cases of pathologic infant weight loss after delivery.
Anterior choroid plexus cysts: Distinction from germinolysis by high‐resolution sonography
Authors: Van Baalen Andreas , Versmold Hans
Published: February 2008

Background: The aim of the present paper was to develop criteria identifying anterior choroid plexus cysts (ACPC) and distinguish these from germinolytic pseudocysts.

Methods: Cerebral sonography was performed in 2200 neonates with mean gestational age 40 completed weeks (range 23–42 weeks) and mean birthweight of 3450 g (range 340–4610 g). In the last 300 neonates cystic formations in the caudothalamic groove were studied prospectively using a high‐resolution ultrasound system with linear scanhead, and the previous results were re‐evaluated.

Results: In 22 neonates choroid plexus cysts outside the typical location in the choroid plexus glomus could be attributed to the anterior part of the choroid plexus in the lateral ventricles (prospectively analyzed in 16 of 300 neonates: 5% prevalence on high‐resolution sonography). ACPC were located medial and behind germinolytic pseudocysts and best realized during sweep of the scanhead through the caudothalamic groove. In contrast to germinolytic pseudocysts, they had a spherical form, no septation and a thick, partial double wall. Larger cysts seemed to bounce.

Conclusions: ACPC are not rare and are identified by their location, form, and movement.
HsCRP levels: Measurement of airway inflammation in asthmatic children
Authors: Soferman Ruth , Glatstein Miguel , Sivan Yakov , Weisman Yosef
Published: February 2008

Background: The inflammatory marker, high‐sensitivity C‐reactive protein (HsCRP), is known to be related to non‐allergic asthma, obesity, cardiovascular disease and smoking in adults. The aim of the present study was to determine whether HsCRP is related to respiratory symptoms and pulmonary function test findings in asthmatic children.

Methods: HsCRP was measured in 63 asthmatic children aged 2–12 years. The measurements were performed in 37 children during an episode of acute exacerbation and in 42 children during remission.

Results: HsCRP level (14.28 ± 8.45 mg/L) during exacerbation was significantly higher than the mean level (1.92 ± 3.16 mg/L) during remission (P < 0.0001), with the decrease being more prominent in children with a low body mass index percentile (P < 0.05). A reciprocal relationship was found between forced expiratory volume in 1 s and high‐sensitivity C‐reactive protein values (P > 0.049).

Conclusion: Elevated HsCRP levels were significantly associated with respiratory impairment in children.
Serum interferon‐γ, interleukin‐4, and interleukin‐6 in infants with adenovirus and respiratory syncytial virus infection
Authors: Oda Keiko , Yamamoto Yukiyo
Published: February 2008

Background: To characterize adenoviral (ADV) infection, the clinical symptoms, laboratory findings and serum cytokine concentrations were evaluated in ADV patients and compared with those in patients with respiratory syncytial virus (RSV) infections.

Methods: A total of 63 patients who had been diagnosed with ADV infections or RSV on an antigen detection test were enrolled in the present study between December 2002 and March 2004. Forty patients had RSV infection and 23 patients had ADV infection. Serum cytokine (interleukin [IL]‐4,6 and interferon [IFN]‐γ) concentrations were analyzed. Concentration of IL‐6 in both infection groups was analyzed regardless of whether the patients had been given steroids (dexamethaxone or prednisolone). In addition, IL‐6 levels were measured on day 1 and 4 of hospitalization.

Results: A strong inflammatory response was observed in patients with ADV infection. Serum IL‐6 levels in patients with ADV infection on day 4 of hospitalization were significantly higher than those in patients without steroids treatment or in patients with RSV infection. IL‐4, and IFN‐γ were not significantly different.

Conclusion: Patients with ADV infections who were given steroids had a temporary increase of IL‐6, which might have indicated the development of a severe clinical course if not been administered.
Theophylline‐associated seizures and their clinical characterizations
Authors: Korematsu Seigo , Miyahara Hiroaki , Nagakura Tomokazu , Suenobu Soichi , Izumi Tatsuro
Published: February 2008

Background: To elucidate the basic mechanism of theophylline‐associated seizures (TAS), the clinical symptoms, electroencephalogram (EEG) and neuroradiological imaging of eight pediatric patients were all retrospectively evaluated.

Methods: Patients whose seizures represented their first episode were selected, while patients with cerebrospinal fluid abnormalities including pleocytosis and protein elevation, present illness of head trauma, epilepsy, febrile convulsion or any psychomotor retardation were excluded although they were given theophylline.

Results: Eight patients, 3.5 ± 1.7 years of age, thus fulfilled the definition of TAS in the past 5 years. Based on their seizure patterns, EEG findings, brain single‐photon emission computed tomography and head magnetic resonance imaging, a total of seven of eight patients had either localized or unilateral dominant lesions. They all had fever, ≥38°C, and six of eight patients had a family history of febrile convulsions and/or idiopathic epilepsy. Thereafter none of them had convulsions after the cessation of theophylline administration. Through the TAS event, a 6‐year‐old female patient was found to have a right deep lateral cerebral venous angioma.

Conclusion: In infants with idiopathic low seizure threshold and fever, theophylline administration might possibly trigger a seizure. Moreover, based on these patients’ clinical findings, some kind of cerebral vascular involvements is speculated to be related with TAS.
Nasal flow‐synchronized intermittent positive pressure ventilation to facilitate weaning in very low‐birthweight infants: Unmasked randomized controlled trial
Authors: Moretti Corrado , Giannini Luigi , Fassi Carla , Gizzi Camilla , Papoff Paola , Colarizi Patrizia
Published: February 2008

Background: Nasal flow‐synchronized intermittent positive pressure ventilation (NFSIPPV) is a new non‐invasive ventilatory mode that delivers synchronized mechanical breaths through the nasal prongs. An unmasked, prospective randomized controlled trial was conducted to compare the efficacy of NFSIPPV and conventional nasal continuous positive airway pressure (NCPAP) in increasing the likelihood for successful extubation in very low‐birthweight infants.

Methods: Consecutive infants who weighed <1251 g at birth, required endotracheal intubation within 48 h of birth and met specific predetermined criteria for extubation by day 14 of life were recruited. Each infant was randomized to receive either NFSIPPV or NCPAP soon after extubation. Extubation was deemed successful if re‐intubation was not needed for at least 72 h. Criteria for re‐intubation were persistent severe respiratory acidosis (arterial pH <7.20 with pCO2 >70 mmHg), severe recurrent apneic episodes not responding to increased ventilatory settings and then requiring bag ventilation, and hypoxemia (SaO2 <90% or pO2 <60 mmHg with FiO2 ≥0.70).

Results: There were no significant differences in clinical characteristics between the two groups at randomization. Ninety‐four percent (30/32) infants were successfully extubated to NFSIPPV but only 61% (19/31) to conventional NCPAP (P > 0.005). Infants assigned to NCPAP failed extubation mainly because of apnea and hypercapnia, and those assigned to NFSIPPV because of hypoxia. Neither procedure induced major adverse effects.

Conclusions: NFSIPPV in the post‐extubation period is safe and more effective than NCPAP in preventing re‐ventilation.
Gastrointestinal sequelae in survivors of congenital diaphragmatic hernia
Authors: Arena Francesco , Romeo Carmelo , Baldari Sergio , Arena Salvatore , Antonuccio Pietro , Campennì Alfredo , Zuccarello Biagio , Romeo Giuseppe
Published: February 2008

Background: Gastrointestinal sequelae have been sporadically reported in survivors of congenital diaphragmatic hernia (CDH). The aim of the present paper was to evaluate the gastrointestinal morbidity in infant, adolescent and adult patients who had undergone repair of CDH.

Methods: Thirty‐one of 38 survivors after left‐side CDH repair were followed up. They were subdivided in two groups. Group A consisted of 12 patients (39%) with a mean age of 4.5 years and group B, 19 patients (61%) with a mean age of 21.0 years. Patients underwent physical examination, barium meal study, gastroesophageal scintigraphy, esophageal pH monitoring and manometry of the esophagus and stomach. Upper intestinal endoscopy was performed in patients with confirmed gastroesophageal reflux (GER).

Results: All patients were within the normal range for height or weight. A total of 41.7% of group A and 15.8% of group B had typical symptoms suggesting GER. Barium meal study was pathological in 33.3% of group A and 21% of group B patients. In 58% of group A and 42% of group B, GER was documented on scintigraphy. In 41.7% of group A and 47% of group B the time taken for the stomach to empty half of its radioactive content (T½) was pathological. On 24 h pH monitoring pathological GER was documented in 54.5%, whereas in group B it was present in 33.3%. In 36.4% of group A and 46.7% of group B alteration of peristalsis of the stomach was recorded. Endoscopy showed esophageal pathology in 33%.

Conclusions: Foregut dysmotility and GER are major sequelae in survivors of CDH repair. Long‐term follow up of patients with CDH is recommended.
T‐helper 1‐related chemokines in the exacerbation of childhood asthma
Authors: Lai Shu‐Tse , Hung Chih‐Hsing , Hua Yi‐Ming , Hsu Shih‐Hsien , Jong Yuh‐Jyh , Suen Jau‐Ling
Published: February 2008

Background: T‐helper (Th) 2 cytokines are thought to mediate most of the allergic inflammatory responses associated with atopic asthma. But the Th1‐related chemokine, interferon‐inducible protein 10 (IP‐10)/CXCL10, was the predominant chemokine measured during human allergic pulmonary late‐phase reaction. The aim of the present study was to evaluate the role of Th1‐ and Th2‐ related chemokines in the pathogenesis of asthma exacerbation.

Methods: Plasma levels of the Th2‐related C‐C chemokine I‐309 (CCL1), the Th1‐related CXC chemokines IP‐10, and the monokine induced by interferon‐γ (Mig)/CXCL9 were measured in patients with stable asthma.

Results: These results were compared to the results measured prior to, and after corticosteroid treatment, in patients who experienced asthma exacerbations. A significant increase in the plasma levels of IP‐10 and Mig, but not I‐309, were found in patients with an acute exacerbation in contrast to patients with stable asthma. Plasma levels of IP‐10 and Mig were significantly higher in patients during an acute asthma exacerbation than during a subsequent convalescent period.

Conclusions: The Th1‐related CXC chemokines IP‐10 and Mig may be useful inflammatory markers of asthma exacerbation in children.
Reaching activity in parietal area V6A of macaque: eye influence on arm activity or retinocentric coding of reaching movements?
Authors: Marzocchi Nicoletta , Breveglieri Rossella , Galletti Claudio , Fattori Patrizia
Published: February 2008

Parietal area V6A contains neurons modulated by the direction of gaze as well as neurons able to code the direction of arm movement. The present study was aimed to disentangle the gaze effect from the effect of reaching activity upon single V6A neurons. To this purpose, we used a visuomotor task in which the direction of arm movement remained constant while the animal changed the direction of gaze. Gaze direction modulated reach‐related activity in about two‐thirds of tested neurons. In several cases, modulations were not due to the eye‐position signal per se, the apparent eye‐position modulation being just an epiphenomenon. The real modulating factor was the location of reaching target with respect to the point gazed by the animal, that is, the retinotopic coordinates towards which the action of reaching occurred. Comparison of neural discharge of the same cell during execution of foveated and non‐foveated reaching movements, performed towards the same or different spatial locations, confirmed that in a part of V6A neurons reaching activity is coded retinocentrically. In other neurons, reaching activity is coded spatially, depending on the direction of reaching movement regardless of where the animal was looking at. The majority of V6A reaching neurons use a system that encompasses both of these reference frames. These results are in line with the view of a progressive visuomotor transformation in the dorsal visual stream, that changes the frame of reference from the retinocentric one, typically used by the visual system, to the arm‐centred one, typically used by the motor system.
Cumulative sessions of repetitive transcranial magnetic stimulation (rTMS) build up facilitation to subsequent TMS‐mediated behavioural disruptions
Authors: Valero‐Cabré Antoni , Pascual‐Leone Alvaro , Rushmore Richard J.
Published: February 2008

A single session of repetitive transcranial magnetic stimulation (rTMS) can induce behavioural effects that outlast the duration of the stimulation train itself (off‐line effects). Series of rTMS sessions on consecutive days are being used for therapeutic applications in a variety of disorders and are assumed to lead to the build‐up of cumulative effects. However, no studies have carefully assessed this notion. In the present study we applied 30 daily sessions of 1 Hz rTMS (continuous train of 20 min) to repeatedly modulate activity in the posterior parietal cortex and associated neural systems in two intact cats. We assessed the effect on visuospatial orientation before and after each stimulation session. Cumulative sessions of rTMS progressively induced visuospatial neglect‐like ‘after‐effects’ of greater magnitude (from 5–10% to 40–50% error levels) and increasing spatial extent (from 90–75° to 45–30° eccentricity locations), affecting the visual hemifield contralateral to the stimulated hemisphere. Nonetheless, 60 min after each TMS session, visual detection–localization abilities repeatedly returned to baseline levels. Furthermore, no lasting behavioural effect could be demonstrated at any time across the study, when subjects were tested 1 or 24 h post‐rTMS. We conclude that the past history of periodically cumulative rTMS sessions builds up a lasting ‘memory’, resulting in increased facilitation to subsequent TMS‐induced disruptions. Such a phenomenon allows a behavioural effect of progressively higher magnitude, but equal duration, in response to individual TMS interventions.
Reduction in memory in passive avoidance learning, exploratory behaviour and synaptic plasticity in mice with a spontaneous deletion in the ubiquitin C‐terminal hydrolase L1 gene
Authors: Sakurai Mikako , Sekiguchi Masayuki , Zushida Ko , Yamada Kazuyuki , Nagamine Satoshi , Kabuta Tomohiro , Wada Keiji
Published: February 2008

Overexpression of ubiquitin C‐terminal hydrolase L1 (UCH‐L1) in mice rescues amyloid β‐protein‐induced decreases in synaptic plasticity and memory. However, the physiological role of UCH‐L1 in the brain is not fully understood. In the present study, we investigated the role of UCH‐L1 in the brain by utilizing gracile axonal dystrophy (gad) mice with a spontaneous deletion in the gene Uch‐l1 as a loss‐of‐function model. Although gad mice exhibit motor paresis beginning at ∼ 12 weeks of age, it is possible to analyse their brain phenotypes at a younger age when no motor paresis is evident. Maintenance of memory in a passive avoidance test and exploratory behaviour in an open field test were reduced in 6‐week‐old gad mice. The maintenance of theta‐burst stimulation‐induced long‐term potentiation (LTP) of field synaptic responses from Schaffer collaterals to CA1 pyramidal cells in hippocampal slices was also impaired in gad mice. The LTP in gad mice was insensitive to actinomycin D, suggesting that a transcription‐dependent component of the LTP is impaired. Phosphorylation of cyclic AMP response element binding protein (CREB) in the CA1 region of hippocampal slices from gad mice occurred earlier than in the slices from wild‐type mice and was transient, suggesting that CREB phosphorylation is altered in gad mice. These results suggest that memory in passive avoidance learning, exploratory behaviour and hippocampal CA1 LTP are reduced in gad mice. We propose that UCH‐L1‐mediated maintenance of the temporal integrity and persistence of CREB phosphorylation underlies these impairments.
Long‐term anal continence and quality of life following postpartum anal sphincter injury
Authors: Samarasekera D. N. , Bekhit M. T. , Wright Y. , Lowndes R. H. , Stanley K. P. , Preston J. P. , Preston P. , Speakman C. T. M.
Published: February 2008

Objective  Anal incontinence occurs as a result of damage to pelvic floor and the anal sphincter. In women, vaginal delivery has been recognized as the primary cause. To date, figures quoted for overt third degree anal sphincter tear vary between 0% and 26.9% of all vaginal deliveries and the prevalence of anal incontinence following primary repair vary between 15% and 61%. Our aim was to analyse the long‐term (minimum 10 years post primary repair) anorectal function and quality of life in a cohort of women who suffered a third degree tear (Group 1) and compare the results with a cohort of women who underwent an uncomplicated vaginal delivery (Group 2) or an elective caesarean delivery (Group 3).

Method  In all, 107 patients who suffered a third degree tear between 1981 and 1993 were contacted with a validated questionnaire. The two control groups comprised of 125 patients in each category. Those who responded to the questionnaire were invited for anorectal physiology studies and endoanal ultrasound.

Results  Of the total number contacted, 54, 71 and 54 women from the three groups returned the completed questionnaire. In the three groups, a total of 28 (53%), 13 (19%) and six (11%) complained of anal incontinence (P < 0.0001) respectively. Comparison of quality of life scores between the groups showed a poorer quality of life in those who suffered a tear (P < 0.0001). In addition, in spite of primary repair, 13 (59%) patients in group 1 showed a persistent sphincter defect compared to one (4%) occult defect in Group 2 and none in Group 3.

Conclusion  Our study indicates that long‐term results of primary repair are not encouraging. It therefore emphasizes the importance of primary prevention and preventing further sphincter damage in those who have already suffered an injury (during subsequent deliveries).
STATISTICAL TRENDS AND HISTORICAL CHANGES
Authors: KUZNETS SIMON
Published: February 2008

The aim of these notes is to examine the uses of statistical data in the study of long‐term changes in the economies of nations. They deal with the general characteristics of data serving as raw material for the study of historical change; the specific characteristics of statistical data; the ways in which these diverse raw materials are organized in systematic accounts; the easy pitfalls in generalizing from statistics; and, in conclusion, the possibilities of statistical analysis of economic growth during the recent stretch of human history.
ENGLISH HUSBANDRY
Authors: Kerridge Eric
Published: February 2008

R. Trow‐Smith, English Husbandry. (Faber and Faber, 1951. Pp. 239. 18s.)
Congenital cytomegalovirus infection following primary maternal infection in the third trimester
Authors: Gindes L , Teperberg‐Oikawa M , Sherman D , Pardo J , Rahav G
Published: February 2008

Objective  To determine the effect of primary cytomegalovirus (CMV) infection in the third trimester on fetal outcome.

Design  Observational study.

Setting  Four perinatal departments in tertiary hospitals in Israel.

Population  Twenty‐eight women with primary CMV infection acquired after 25 weeks of gestation.

Methods  Prenatal evaluation included amniocentesis and ultrasonographic examinations. Maternal infection was determined from seroconversion and presence of low avidity anti‐CMV immunoglobulin G after 25 weeks of gestation. Fetal CMV infection was diagnosed from CMV isolated or CMV DNA amplified from the amniotic fluid. Neonatal infection was established from CMV presence in their urine or anti‐CMV IgM was in their peripheral blood immediately after birth. All liveborn neonates underwent cerebral ultrasonography, hearing assessment, and psychomotor development evaluation. Infected neonates were followed up for a median of 36 months (range 6–36 months).

Main outcome measures  Intrauterine CMV infection and neonatal CMV disease throughout follow up.

Results  Vertical transmission of CMV was documented in 21 (75%) of the 28 pregnancies. None of the 20 live infected newborn had symptomatic congenital infection. One pregnancy was terminated at 34 weeks following evidence of prenatal infection. Most of the patients (75%) had CMV serology test due to clinical signs of CMV disease.

Conclusions  Although CMV infection during the third trimester of pregnancy is highly transmissible, sequelae were not found among infected offspring.
Genetic variants of interleukin‐1RN and interleukin‐1β genes and risk of cervical cancer
Authors: Singh H , Sachan R , Goel H , Mittal B
Published: February 2008

Objectives  Inflammation plays a major role in pathogenesis of cervical cancer. We planned to study whether polymorphisms in inflammation‐related genes, IL‐1RN (VNTR) and IL‐1β (‐511C/T), are associated with risk of cervical cancer.

Design  Case–control study.

Setting  Uttar Pradesh state in India.

Sample  One hundred and fifty, histopathologically confirmed cases with cervical cancer and 162 age‐, ethnicity‐matched, cervical cytology negative, healthy controls were recruited to this study.

Methods  Genotyping of IL‐1RN (VNTR) and IL‐1β (‐511C/T) polymorphisms was performed using polymerase chain reaction (PCR)/PCR–restriction fragment length polymorphism. Power of study was 80% with type 1 error of 0.05. Haplotypes frequencies were obtained by computer package ‘Arlequin’.

Main outcome measures  Haplotype IL‐1RN*2/IL‐1β*T is associated with higher risk and of cervical cancer.

Results  IL‐1RN genotypes 1/2 and 2/2 were associated with significantly elevated risk of cervical cancer (OR = 3.3; P= 4.9 × 10−6 and OR = 2.9, P= 0.02). Similarly, TT genotype of IL‐1βpolymorphism was significantly higher in cases compared with controls (57.7 versus 38.3%; OR = 2.8; P = 0.012). 2/2 genotype of IL‐1RN (OR = 4.8, P = 0.0006) and TT genotype of IL‐1β(OR = 5.2; P = 0.02) were associated with the higher stages (III) of cervical cancer. Haplotypes 1T (IL‐1RN*1/IL‐1β*T) and 2T (IL‐1RN*2/IL‐1β*T) were also significantly associated with higher susceptibility to cervical cancer and its progression. Logistic regression analysis suggests IL‐1RN allele 2 and IL‐1β‐511T were independently associated with increased risk for cervical cancer.

Conclusion  IL‐1RN*2 and IL‐1β ‐511*T in various combinations of genotypes and haplotypes are associated with higher susceptibility for cervical cancer.
Altered bacterial metabolism, not coenzyme Q content, is responsible for the lifespan extension in Caenorhabditis elegans fed an Escherichia coli diet lacking coenzyme Q
Authors: Saiki Ryoichi , Lunceford Adam L. , Bixler Tarra , Dang Peter , Lee Wendy , Furukawa Satoru , Larsen Pamela L. , Clarke Catherine F.
Published: February 2008

Coenzyme Qn is a fully substituted benzoquinone containing a polyisoprene tail of distinct numbers (n) of isoprene groups. Caenorhabditis elegans fed Escherichia coli devoid of Q8 have a significant lifespan extension when compared to C. elegans fed a standard ‘Q‐replete’E. coli diet. Here we examine possible mechanisms for the lifespan extension caused by the Q‐less E. coli diet. A bioassay for Q uptake shows that a water‐soluble formulation of Q10 is effectively taken up by both clk‐1 mutant and wild‐type nematodes, but does not reverse lifespan extension mediated by the Q‐less E. coli diet, indicating that lifespan extension is not due to the absence of dietary Q per se. The enhanced longevity mediated by the Q‐less E. coli diet cannot be attributed to dietary restriction, different Qn isoforms, reduced pathogenesis or slowed growth of the Q‐less E. coli, and in fact requires E. coli viability. Q‐less E. coli have defects in respiratory metabolism. C. elegans fed Q‐replete E. coli mutants with similarly impaired respiratory metabolism due to defects in complex V also show a pronounced lifespan extension, although not as dramatic as those fed the respiratory deficient Q‐less E. coli diet. The data suggest that feeding respiratory incompetent E. coli, whether Q‐less or Q‐replete, produces a robust life extension in wild‐type C. elegans. We believe that the fermentation‐based metabolism of the E. coli diet is an important parameter of C. elegans longevity.
Symptomatic urinary stone disease in pregnancy
Authors: CHERIACHAN Deepak , ARIANAYAGAM Mohan , RASHID Prem
Published: February 2008

Background:  Symptomatic urinary calculi are rare in pregnancy with an incidence of one per 1500 pregnant women. Calculi may cause ureteric obstruction that can be further complicated by sepsis. This may have a significant morbidity for mother and fetus.

Objective:  To provide an update on the current investigations and management options for pregnant patients with symptomatic urinary calculi.

Discussion:  We discuss the different imaging modalities available to investigate the renal tract in pregnant women and propose a management pathway. This topic is particularly pertinent to obstetricians in their roles as coordinators of prenatal care.
Venous thromboembolism during pregnancy and the post‐partum period: Incidence and risk factors in a large Victorian health service
Authors: SHARMA Sanjay , MONGA Deepika
Published: February 2008

Background:  There is a strong recommendation for post‐partum thromboprophylaxis following emergency caesarean sections, particularly in overweight women, and following prolonged labour.

Aims:  To analyse the incidence and epidemiological factors associated with antepartum and post‐partum venous thromboembolism in a large Victorian health service.

Methods:  A retrospective study of all 6987 women delivering at Ballarat Health Services between March 1999 and June 2006. Case notes of women with confirmed venous thromboembolism during this period were subjected to detailed analysis. The data were analysed for possible risk factors, the timing of thromboembolism in relation to the pregnancy and any correlation with thromboprophylaxis, if administered.

Results:  The rate of venous thromboembolism was 1.14 per 1000 deliveries, with risk factors of age > 30 (100%), obesity (75%), previous history of thromboembolism (62.5%) and caesarean section (37.5%). Majority of cases were diagnosed in first trimester (62.5%), and in the right lower limb (75%). None of the patients had been given thromboprophylaxis.

Conclusion:  While the incidence and risk factors were similar to those generally quoted, a much higher incidence was found in early pregnancy, and in the right lower limb. The importance of meticulous screening for risk factors in early pregnancy cannot be overemphasised.
Progesterone for maintenance tocolytic therapy after threatened preterm labour: A randomised controlled trial
Authors: BORNA Sedigheh , SAHABI Noshin
Published: February 2008

Background:  Women with preterm labour that is arrested with tocolytic therapy are at increased risk of recurrent preterm labour. The efficacy of maintenance tocolytic therapy after successful arrest of preterm labour remains controversial.

Aim:  The purpose of this study was to determine whether supplementation of vaginal progesterone after inhibition of preterm labour is associated with an increased latency period and a decreased recurrent of preterm labour.

Methods:  This trial was conducted in 70 women who presented with symptoms of threatened preterm labour, who after arrest of uterine activity were then randomised to progesterone therapy or no treatment. Treatment group received progesterone suppository (400 mg) daily until delivery and control group received no treatment.

Results:  Longer mean latency until delivery (36/11 ± 17/9 vs 24/52 ± 27/2) (mean + standard deviation) days; respiratory distress syndrome 4 (10.8%) vs 12 (36.4%) P = 0.021; low birthweight 10 (27%) vs 17 (51.5%) P = 0.04; and birthweight (3101.54 ± 587.9 g vs r 2609.39 ± 662.9 g, P = 0.002), were significantly different between the two groups.

No significant differences were found between recurrent preterm labour 13 (35.1%) vs 19 (57.6%), P = 0.092; admission to intensive care unit 9 (24.3%) vs 13 (39.4%), P= 0.205 ; and neonatal sepsis 2 (5.4%) vs 6 (18.2%) P = 0.136, for the progesterone and control groups, respectively.

Conclusion:  The use of vaginal progesterone suppository after successful parenteral tocolysis associated with a longer latency preceding delivery but failed to reduce the incidence of readmission for preterm labour.
A randomised comparison between sublingual, oral and vaginal route of misoprostol for pre‐abortion cervical ripening in first‐trimester pregnancy termination under local anaesthesia
Authors: SAXENA Pikee , SARDA Nivedita , SALHAN Sudha , NANDAN Deoki
Published: February 2008

Objective:  To compare efficacy of sublingual (S/L), oral and vaginal routes of misoprostol administration for cervical priming before suction evacuation (SE) under local anaesthesia.

Methods:  In a prospective randomised clinical trial, 200 women in the first trimester of pregnancy were randomised into four groups of 50 each. Patients in control group did not receive any medication before SE while other treatment groups received 400 µg of misoprostol three hours prior to SE either by sublingual/oral or by vaginal route. Main outcome measure was basal cervical dilatation while the secondary outcome measures were operative blood loss, time duration of surgery, patient satisfaction, pain perception and adverse effects.

Results:  Sublingual group had a higher dilatation (9.9 ± 2.1 mm; P < 0.001) and lower time duration of surgery (3.6 ± 1.0 min; P < 0.01) as compared to oral (8.2 ± 2.6 mm, 4.9 ± 1.7 min) or vaginal routes (7.6 ± 2.6 mm, 5.2 ± 1.8 min). Mean pain score of the sublingual group was significantly lower (2.4 + 1.3; P < 0.001) as compared to oral (3.4 ± 1.3) or vaginal routes (3.6 ± 1.2). Patient acceptability was higher for sublingual (53 of 150) and oral routes (62 of 150) as compared to vaginal (35 of 150) route.

Conclusion:  Sublingual route was significantly more effective than oral or vaginal administration of misoprostol for cervical dilatation. To the best of our knowledge, this is the first study to simultaneously compare the efficacy of sublingual, oral and vaginal routes of misoprostol for cervical priming before SE.
Enough is enough! Time for a new model of care for women with early pregnancy complications
Authors: CONDOUS George
Published: February 2008

Australian women with early pregnancy complications, like their English counterparts, should have access to ultrasound‐based early pregnancy units (EPUs) nationwide. This modern approach to women with first trimester problems would not only streamline individual care pathways but also reduce the impact that early pregnancy problems have on already overburdened public emergency departments. Dedicated EPUs, with trained gynaecological sonologists experienced in the management of first trimester complications, should become the benchmark standard of care for Australian women in early pregnancy.
Guidelines for the use of recombinant activated factor VII in massive obstetric haemorrhage
Authors: WELSH Alec , McLINTOCK Claire , GATT Stephen , SOMERSET David , POPHAM Phillip , OGLE Robert
Published: February 2008

Recombinant activated factor VII (rFVIIa) is emerging as a novel therapy for the treatment of life or fertility‐threatening post‐partum haemorrhage (PPH) unresponsive to standard therapy that in some cases may prevent the need for peripartum hysterectomy. The level of evidence to date for use of rFVIIa in PPH is limited to case reports and case series with one nonrandomised study. No high‐quality randomised controlled trials have been published at this stage, precluding a quality systematic review. Guidelines have been published for the use of rFVIIa in non‐obstetric haemorrhage, though to date none are available for PPH. A multidisciplinary group of Australian and New Zealand clinicians from the fields of obstetrics, anaesthesia and haematology, who have both clinical experience in and/or knowledge of rFVIIa was convened by the manufacturer. This group produced an opinion and guideline based on their experience and the published international literature on the use of rFVIIa. This is intended to be used as a guideline and algorithm for the use of rFVIIa, though any use should be tailored to local practice and resources.
Calculated phase equilibria involving chemical potentials to investigate the textural evolution of metamorphic rocks
Authors: WHITE R. W. , POWELL R. , BALDWIN J. A.
Published: February 2008

Evolving pressure–temperature conditions during metamorphism drive changes in the stable mineral assemblage, mineral proportions and mineral compositions in rocks. These changes are achieved via the diffusion of components between minerals, fluid and melt, the driving force for diffusion being the gradients in chemical potential of the components developed spatially within the rock. This study utilises recent developments in the software thermocalc to investigate quantitatively chemical potential relationships in rocks, with the phases involved being (solid) solutions. Phase diagrams with chemical potentials as axes are used to understand better the spatial rearrangement of components during the metamorphic evolution of rocks and the metamorphic textures that result. In contrast to qualitative chemical potential diagrams, quantitative diagrams can be contoured for mineral composition, allowing consideration of chemical zoning in minerals. Furthermore, the amount of material required to diffuse to equalise chemical potentials can be calculated. We start by demonstrating the approach via an example of retrograde corona development in an ultra‐high‐temperature granulite. Whereas the use of chemical potentials to consider the retrograde development of corona textures is well known, they are also significant in considering the prograde history. The role of chemical potentials in prograde metamorphic textural evolution is highlighted in consideration of the consumption and growth of aluminosilicates during the kyanite‐to‐sillimanite reaction, and the growth of garnet porphyroblasts.
Refining the P–T records of UHT crustal metamorphism
Authors: HARLEY S. L.
Published: February 2008

Ultra‐high‐temperature (UHT) metamorphism occurs when the continental crust is subjected to temperatures of greater than 900 °C at depths of 20–40 km. UHT metamorphism provides evidence that major tectonic processes may operate under thermal conditions more extreme than those generally produced in numerical models of orogenesis. Evidence for UHT metamorphism is recorded in mineral assemblages formed in magnesian pelites, supported by high‐temperature indicators including mesoperthitic feldspar, aluminous orthopyroxene and high Zr contents in rutile. Recent theoretical, experimental and thermodynamic data set constraints on metamorphic phase equilibria in FMAS, KFMASH and more complex chemical systems have greatly improved quantification of the P–T conditions and paths of UHT metamorphic belts. However, despite these advances key issues that remain to be addressed include improving experimental constraints on the thermodynamic properties of sapphirine, quantifying the effects of oxidation state on sapphirine, orthopyroxene and spinel stabilities and quantifying the effects of H2O–CO2 in cordierite on phase equilibria and reaction texture analysis. These areas of uncertainty mean that UHT mineral assemblages must still be examined using theoretical and semi‐quantitative approaches, such as P(–T)–μ sections, and conventional thermobarometry in concert with calculated phase equilibrium methods. In the cases of UHT terranes that preserve microtextural and mineral assemblage evidence for steep or ‘near‐isothermal’ decompression P–T paths, the presence of H2O and CO2 in cordierite is critical to estimates of the P–T path slopes, the pressures at which reaction textures have formed and the impact of fluid infiltration. Many UHT terranes have evolved from peak P–T conditions of 8–11 kbar and 900–1030 °C to lower pressure conditions of 8 to 6 kbar whilst still at temperature in the range of 950 to 800 °C. These decompressional P–T paths, with characteristic dP/dT gradients of ∼25 ± 10 bar °C−1, are similar in broad shape to those generated in deep‐crustal channel flow models for the later stages of orogenic collapse, but lie at significantly higher temperatures for any specified pressure. This thermal gap presents a key challenge in the tectonic modelling of UHT metamorphism, with implications for the evolution of the crust, sub‐crustal lithosphere and asthenospheric mantle during the development of hot orogens.
Obesity and Functional Disability in Elderly Americans
Authors: Chen Honglei , Guo Xuguang
Published: February 2008

OBJECTIVES: To investigate whether indicators of obesity are associated with functional disabilities in elderly American women and men.

DESIGN: Cross‐sectional.

SETTING: National Health and Nutrition Examination Survey (NHANES) 1999 to 2004, United States.

PARTICIPANTS: One thousand six hundred eighty‐four elderly (aged ≥60) women and 1,611 elderly men.

MEASUREMENTS: Functional disabilities.

RESULTS: In women, body mass index (BMI) and waist circumference were each related to higher prevalence of all measures of disabilities. Compared with the lowest quartile of waist circumference, the multivariate odds ratios (ORs) of the highest quartile for having difficulties in functional domains were 2.4 (95% confidence interval (CI)=1.6–3.6) for activities of daily living, 2.3 (95% CI=1.6–3.3) for instrumental activities of daily living, 2.6 (95% CI=1.6–4.1) for leisure and social activities, 4.8 (95% CI=3.4–6.9) for lower extremity mobility, and 2.9 (95% CI=2.1–4.0) for general physical activity. In men, these associations were moderate; the corresponding ORs were 1.2 (95% CI=0.8–2.0), 1.3 (95% CI=0.9–2.1), 2.1 (95% CI=1.2–3.7), 1.8 (95% CI=1.2–2.7), and 2.1 (95% CI=1.5–2.8), respectively. Similar results were obtained for BMI. These associations could not be explained by the presence of major chronic conditions. When adjusted simultaneously, waist circumference appeared to be a better predictor than BMI of disability in women.

CONCLUSION: The results suggest that indicators of obesity are related to functional disabilities in elderly Americans.
Bayesian Analysis of Wildlife Age‐at‐Harvest Data
Authors: Conn Paul B. , Diefenbach Duane R. , Laake Jeffrey L. , Ternent Mark A. , White Gary C.
Published: February 2008

Summary State and federal natural resource management agencies often collect age‐structured harvest data. These data represent finite realizations of stochastic demographic and sampling processes and have long been used by biologists to infer population trends. However, different sources of data have been combined in ad hoc ways and these methods usually failed to incorporate sampling error. In this article, we propose a “hidden process” (or state‐space) model for estimating abundance, survival, recovery rate, and recruitment from age‐at‐harvest data that incorporate both demographic and sampling stochasticity. To this end, a likelihood for age‐at‐harvest data is developed by embedding a population dynamics model within a model for the sampling process. Under this framework, the identification of abundance parameters can be achieved by conducting a joint analysis with an auxiliary data set. We illustrate this approach by conducting a Bayesian analysis of age‐at‐harvest and mark‐recovery data from black bears (Ursus americanus) in Pennsylvania. Using a set of reasonable prior distributions, we demonstrate a substantial increase in precision when posterior summaries of abundance are compared to a bias‐corrected Lincoln–Petersen estimator. Because demographic processes link consecutive abundance estimates, we also obtain a more realistic biological picture of annual changes in abundance. Because age‐at‐harvest data are often readily obtained, we argue that this type of analysis provides a valuable strategy for wildlife population monitoring.
Extending the Modified Bayesian Information Criterion (mBIC) to Dense Markers and Multiple Interval Mapping
Authors: Bogdan Małgorzata , Frommlet Florian , Biecek Przemysław , Cheng Riyan , Ghosh Jayanta K. , Doerge R.W.
Published: February 2008

Summary The modified version of Bayesian Information Criterion (mBIC) is a relatively simple model selection procedure that can be used when locating multiple interacting quantitative trait loci (QTL). Our earlier work demonstrated the statistical properties of mBIC for situations where the average genetic map interval is at least 5 cM. In this work mBIC is adapted to genome searches based on a dense map and, more importantly, to the situation where consecutive QTL and interactions are located by multiple interval mapping. Easy to use formulas for the extended mBIC are given. A simulation study, as well as the analysis of real data, confirm the good properties of the extended mBIC.
A Fatal Case of Suspected Anaphylaxis with Cefoperazone and Sulbactam: LC‐MS Analysis
Authors: Tsujikawa Kenji , Kuwayama Kenji , Miyaguchi Hajime , Kanamori Tatsuyuki , Iwata Yuko , Inoue Hiroyuki , Kishi Tohru
Published: February 2008

Cefoperazone and sublactam are prescribed in combination and used in the treatment of moderate to severe bacterial infections. Serious anaphylaxis is a rare side effect. This report describes a fatal case of suspected anaphylaxis after intravenous administration of a combination of the two drugs. Heart blood was analyzed for cefoperazone by protein precipitation with acetonitrile and by liquid‐liquid precipitation for sublactam after protein precipitation with aqueous acetonitrile, followed by tandem mass spectrometry in the product ion scan mode for identification and by liquid chromatography mass spectrometry in the selected ion monitoring mode for quantitation. Calibration curves for cefoperazone and sublactam were linear over the range 0.07 to 1.93 and 0.046 to 0.914 μg/ml respectively. The decedent's blood concentrations of cefoperazone and sublactam were 0.368 and 0.143 μg/ml respectively. As these concentrations were below concentrations reported after single dosing studies and below those considered to be minimally inhibitory, death was presumed to have been caused by hypersensitivity and not an overdose. In conclusion, this procedure is useful for detecting and quantitating cefoperazone and sublactam in postmortem blood and may be useful in the evaluation of anaphylaxis.
Potency of Δ9–THC and Other Cannabinoids in Cannabis in England in 2005: Implications for Psychoactivity and Pharmacology*
Authors: Potter David J. , Clark Peter , Brown Marc B.
Published: February 2008

Abstract:  Gas chromatography was used to study the cannabinoid content (“potency”) of illicit cannabis seized by police in England in 2004/5. Of the four hundred and fifty two samples, indoor‐grown unpollinated female cannabis (“sinsemilla”) was the most frequent form, followed by resin (hashish) and imported outdoor‐grown herbal cannabis (marijuana). The content of the psychoactive cannabinoid Δ9‐tetrahydrocannabinol (THC) varied widely. The median THC content of herbal cannabis and resin was 2.1% and 3.5%, respectively. The median 13.9% THC content of sinsemilla was significantly higher than that recorded in the UK in 1996/8. In sinsemilla and imported herbal cannabis, the content of the antipsychotic cannabinoid cannabidiol (CBD) was extremely low. In resin, however, the average CBD content exceeded that of THC, and the relative proportions of the two cannabinoids varied widely between samples. The increases in average THC content and relative popularity of sinsemilla cannabis, combined with the absence of the anti‐psychotic cannabinoid CBD, suggest that the current trends in cannabis use pose an increasing risk to those users susceptible to the harmful psychological effects associated with high doses of THC.