The effect of passing an "anti-immigrant" ballot proposition on the use of prenatal care by foreign-born mothers in California

This study examines whether the passage of California's Proposition 187, a proposition designed to restrict undocumented immigrants from using public services, had a negative effect on the use of prenatal care and birth outcomes. Comparisons of prenatal care use and birth outcomes before and after the passage of the proposition are made between low-education foreign-born and U.S.-born mothers using California's Birth Public Use files. Multivariate linear and logistic regressions were used to control for regional and maternal characteristics. We find a significant but small decline in the use of prenatal care by low-education foreign-born women after Proposition 187 passed; however, there was no detectable deterioration of birth outcomes. Whether future reductions in the availability of prenatal care would damage the health of children is unclear.     

Apgar scores in low birth weight infants delivered vaginally and by cesarean section

A retrospective investigation of 641 live infants weighing less than 2500 g showed that the frequency of a low Apgar score (less than or equal to 7, five minutes after birth) was significantly correlated to the birth weight of the infant and independent of the mode of delivery and the presentation of the fetus at birth.     

How to use a rotahaler.

The bronchodilator response after five different modes of salbutamol inhalation by rotahaler was assessed in 15 asthmatic children in a double blind cross over study. Inspiratory flow rates lower than 50 litres/minute were associated with a significant reduction in response compared with flow rates higher than 60 litres/minute, but tilting the head back during inhalation and holding the breath for 10 seconds had no significant effect on bronchodilation. Peak inspiratory flow rates measured in 150 normal children and 13 asthmatic children with acute wheeze showed that many young children and many children with severe bronchoconstriction were unable to generate a sufficiently high inspiratory flow rate to obtain maximum benefit from rotahaler treatment. Children using a rotahaler should be taught to inhale as quickly as possible and not with a quiet deep breath as recommended in the instruction leaflets.     

Ovarian cyst fenestration via the laparoscope. A laparoscopic method for treatment of non-neoplastic ovarian cysts

A laparoscopic method of managing macroscopically benign, unilateral, unilocular, mobile, translucent, and smooth-walled ovarian cysts in women of reproductive age is described. The method requires the cutting of a window in the cyst wall through the laparoscope fenestration. In preference to aspiration at laparoscopy or removal at laparotomy, this method has the advantage of ensuring histologic material as well as permanent drainage by the use of atraumatic surgical technique. Nineteen cysts were fenestrated laparoscopically. Four cysts could not be classified, two owing to lack of histologic material, two owing to malpreparation of the selected cyst tissue. In one case an epithelial cyst--a mucinous cystadenoma, being laparoscopically unsuspected--was fenestrated. One cyst recurred. By observing the above criteria it is possible and tolerably safe to select non-neoplastic cysts, for which fenestration should be reserved.     

Effects of presbycusis and other types of hearing loss on auditory brainstem responses

Auditory brainstem responses were studied in 373 healthy individuals of various ages and with sensorineural hearing loss of differing degrees. 209 subjects were elderly and had a hearing loss which included a component of presbycusis. The remainder were young or middle-aged with cochlear hearing loss. Altogether 606 ears were tested. The old individuals had generally longer ABR wave latencies than the young subjects. The I-V interpeak latency (IPL) was also prolonged in the older age groups compared with the group of younger individuals, except for subjects with pronounced hearing loss. The results of the study indicate that an age-related dysfunction of the auditory pathway in the brainstem can be present in presbycusis.     

Reproductive problems and birth defects in survivors of Wilms' tumor and their relatives

In a retrospective cohort study of 47 Wilms' tumor survivors and their 77 sibling controls, female survivors had a fourfold excess risk (risk ratio, 4.1; 95% confidence interval, 1.7-10.1) for any adverse livebirth outcome, including birth defects, compared with their sibling controls. Wives of male survivors had no apparent excess risk for problem pregnancies. The families had a number of severe reproductive problems and major birth defects, such as primary amenorrhea in two survivors, bicornuate uterus in two survivors and one control, and mental retardation in one male survivor and a male control. The son of a female survivor died after bilateral Wilms' tumors. Birth defects in the offspring of female survivors are compatible either with intrauterine constraint, possibly due to radiation-induced fibrosis or with the complex of malformations associated with Wilms' tumor. Female survivors of Wilms' tumor appear to be at increased risk for a variety of reproductive problems, from sterility to fetal loss, early delivery, and birth defects in offspring. Furthermore, relatives of survivors of Wilms' tumor may be at risk of having associated birth defects, with clinically significant consequences.     

A randomized study of cyclophosphamide and cis-platinum with or without doxorubicin in advanced ovarian carcinoma

Two hundred sixty-seven patients with advanced epithelial ovarian carcinoma were randomized to cis-platinum and cyclophosphamide versus cis-platinum, cyclophosphamide, and doxorubicin. Complete pathological response, evaluated at second-look laparotomy and survival, showed no differences between the two treatment groups. Recurrence-free survival after negative second look was 61% at 24 months.     

Histological investigation of skin biopsies in otosclerosis and osteogenesis imperfecta

Summary The hypothesis that homeostatic control mechanisms control mucociliary function in ciliated mucous membrane was tested. Nasal mucociliary transport rates were recorded in chickens in vivo at successive intervals during exposure to SO₂ or after inoculation with Newcastle disease virus (NDV), or both. Either agent alone caused deceleration of the turbinate clearance. However, when SO₂ exposure was limited to one nasal fossa and turbinate mucociliary rates were determined in the unexposed and infected side, the two acted antagonistically and yielded approximately normal rates. Exposure of the nasal mucosae to SO₂ caused decreased rates of sinus clearance, while NDV infection of nasal membranes induced increased rates of sinus clearance. Exposure of nasal mucosae to both agents acted antagonistically to effect rates of sinus clearance in normal ranges. These data support the idea of homeostasis.Research support from NIH grant no. 5 RO1 ES-00741     

Prevalence of antibodies to herpes simplex virus and frequency of HLA antigens in patients with preinvasive and invasive cervical cancer

Previous herpes simplex virus type 2 (HSV-2) infections are known to predispose women for the development of cervical cancer, but causal relationship between the virus and the cancer has never been proven. Forty-six patients with cervical carcinoma (13 with preinvasive lesions and 33 with various stages of invasive disease) were selected for the present study. Among the patients 96% were seropositive for the presence of antibodies to herpes simplex virus compared to 87% of the 30 controls. Antibodies specific for HSV-2 were found in the sera from 24% of the patients and 17% of the controls by the use of an immunoblotting test. Patients and controls were typed for HLA-A,B,C and D/DR antigens, but no significant associations were found.