Decreased Cesarean Birth Rates and Improved Perinatal Outcome: A Seven-Year Study

ABSTRACT: This study examined the decrease in cesarean section rates in relation to perinatal mortality between 1987 and 1993 at the primary referral hospital in north Jordan. Most of the population is at high risk and of low socioeconomic status. The cesarean section rate decreased from 15.5 percent in 1987 to 8.7 percent in 1993, and has remained at this low rate. During the same period the perinatal mortality dropped from 52 to 20.9 deaths per 1000 live births. These results do not include perinatal morbidity. The successful reduction of the cesarean section rate is attributed to active management of labor, trial of labor for women with a previous cesarean birth, and vaginal breech delivery in selected women. We conclude that the rate of cesarean delivery can be safely reduced in a developing country without adverse effects on birth outcomes.     

Munchausen's syndrome. A case of factitious hemoptysis

Factitious hemoptysis is the bleeding type of Munchausen's syndrome, rarely reported in the literature (only seventeen cases). After a careful and detailed literature review, the authors report the case of a 22-year-old working-woman, with a history of asthma, Mediterranean anaemia and recurrent hemoptysis, who was admitted several times to the cardiovascular and Respiratory Sciences Department in the Carlo Forlanini Hospital in 1994 for an asthmatic attack and wheeziness at rest. During the admissions the patient underwent laboratory tests (such as the examination of sputum specimens, urinalysis, tuberculin test, cold agglutinins and pneumotropic virus tests) and diagnostic studies (fiberoptic bronchoscopy with bronchoalveolar lavage, computerized tomography and radiography of the chest, bronchial arteriography, bronchography, perfusion and ventilation lung scan), because she continually presented with hemoptysis, in order to spot and discover the nature of the bleeding. Since such examinations failed (a few of them-namely fiberoptic bronchoscopies--were even performed when she was coughing up blood) and psychiatric consultations revealed the presence of psychologically traumatic events in the patient's history which could explain the psychopathic traits of her personality (in fact she was aggressive and unstable in interpersonal relations), a diagnosis of factitious hemoptysis in Munchausen's syndrome was made.     

Melatonin attenuates hypochlorous acid-mediated heme destruction, free iron release, and protein aggregation in hemoglobin

Abstract: In inflammatory diseases, where hypochlorous acid (HOCl) is elevated, iron homeostasis is disturbed, resulting in accumulation of free iron. Free iron is toxic by virtue of its ability to generate free radicals through the Fenton reaction. HOCl is generated by myeloperoxidase, (MPO) using chloride and hydrogen peroxide as substrates. Recent studies demonstrate that HOCl binds to the heme moiety of hemoglobin (Hb), which generates a transient ferric species whose formation and decay kinetics indicate it participates in protein aggregation, heme destruction, and free iron release. Here, we show that melatonin prevents HOCl‐mediated Hb heme destruction and protein aggregation, using a combination of UV‐vis spectrophotometry, ferrozine colorimetric assay, and in‐gel heme staining. We also show that melatonin treatment prevents HOCl‐mediated loss of red blood cell (RBC) viability, indicating biologic relevance of this finding. The mechanism by which melatonin prevents HOCl‐mediated Hb heme destruction is by direct scavenging of HOCl and/or through the destabilization of the higher Hb oxidative states intermediates, ferryl porphyrin radical cation Hb‐Fe(IV)=O^+π? and Hb‐Fe(IV)=O, which are formed through the reaction of HOCl with Hb. Our work establishes a direct mechanistic link between melatonin and its protective effect in chronic inflammatory diseases. Collectively, in addition to acting as an antioxidant and as a MPO inhibitor, melatonin can also exert its protective effect by inhibiting HOCl‐mediated heme destruction of hemoproteins and subsequent free iron release.     

Kallikrein messenger RNA in rat arteries and veins.

Glandular kallikrein (EC 3.4.21.8) belongs to a subgroup of serine proteases coded by a multigene family. A kininogenase resembling glandular kallikrein has been identified in vascular tissue; however, it is not clear whether it is synthesized by vascular tissue or taken up from plasma. To determine the potential for kallikrein synthesis in vascular tissues, we tested whether messenger RNA (mRNA) for glandular kallikrein is present in rat arteries and veins. Poly(A+) RNA was isolated from pools of arteries or veins (n = 3, 30 rats each). Poly(A+) RNA from the kidney and liver was used as a positive and negative control, respectively. As a probe, we used rat pancreatic kallikrein 32P-labeled complementary DNA, which recognizes mRNA of the entire rat kallikrein family. Slot-blot analysis indicated that kallikrein mRNA was present in mRNA from the arteries, veins, and kidney but not from the liver. Poly(A+) RNA from arteries and veins contained approximately 1% as much kallikrein mRNA as that from the kidney. To confirm the slot-blot results and determine whether the mRNA for true glandular kallikrein was present in vascular tissue, we employed a polymerase chain reaction assay, first using primers specific for the entire kallikrein family (which amplify a 430-bp fragment) and then using primers specific for true glandular kallikrein mRNA (which amplify a 370-bp fragment). After the polymerase chain reaction assay, both arteries and veins showed fragments of these sizes when tested with rat kallikrein complementary DNA probe, thus confirming the presence of glandular kallikrein mRNA.(ABSTRACT TRUNCATED AT 250 WORDS)     

Potentiation of the Cytotoxic Activity of Nutraceutical Phloretin against Cervical Cancer by Formulation into Microemulsion

Pharmaceutical Chemistry Journal - The present study aimed to investigate the cytotoxic effect of phloretin–a nutraceutical found in apples and its nanoparticulated form–on cervical...