Progesterone, selected heavy metals and micronutrients in pregnant Nigerian women with a history of recurrent spontaneous abortion

Background

Environmental and endocrine factors have been implicated in the aetiology of recurrent abortion, with poorly understood roles. Luteal phase insufficiency marked with insufficient progesterone secretion has been reported.

Objective

To define the involvement of progesterone, trace metals, and Vitamin E in pregnant women with history of recurrent spontaneous abortion.

Methods

Convenience sampling method was used to recruit 69 pregnant women aged 21–41 years with gestational age of 0–20 weeks in this case-control study. Thirty five (cases) and thirty four (controls) had previous and no history of recurrent spontaneous abortion respectively. Demographic characteristics and 10mls of blood samples were obtained from each subject. Serum obtained was used for the determination of progesterone, zinc, copper, selenium, iron, magnesium, manganese, chromium, lead, cadmium, and serum vitamin E by standard methods.

Results

Results showed statistically significant decreases (p<0.05) in the serum zinc, copper, and vitamin E and a significant elevation (p<0.05) in the serum selenium, lead, and cadmium in cases compared with controls. Insignificant decrease (p=0.07) was observed in the serum progesterone when cases were compared with controls.

Conclusion

Results suggest that elevated serum heavy metals (cadmium and lead) and reduction of essential micronutrients (zinc, copper and vitamin E) may contribute to recurrent spontaneous abortion.     

Relation between faecal fat and energy in preterm infants

The energy measured in the faeces correlated highly (r = 0.93) with faecal fat in 111 24-hour stool collections from 37 preterm infants. It is easier to measure faecal energy than faecal fat, and energy measurements provide a better indication of nutrient malabsorption than faecal fat alone.     

USE OF ANTIBIOTICS AFTER COMPLEX OPEN HAND INJURY

SUMMARY A prospective study undertaken to examine bacterial contamination at presentation, frequency and type of antibiotic prescribed, and outcome, in 50 patients presenting with hand injuries of varying severity, is reported. Results of a national survey of trends in antibiotic prescribing for similar wounds in plastic surgery units are also recorded. Preoperative swabs cultured normal flora or no growth. Forty-eight patients received antibiotics with little consistency in the agent used, route of administration, or length of treatment. Clinical wound infection occurred in three crush injuries. No significant difference in the numbers of surgeons using antibiotics for clean and crushed injuries of all types was demonstrated. The state of the wound, rather than the tissue damaged, seemed to dictate antibiotic use. In dirty wounds, however, damage to deep structures appeared to be an indication for antibiotics — significantly fewer respondents treated dirty injuries of the skin alone. The authors believe that antibiotic use in open hand injury is of no proven benefit, and that this aspect of hand surgery requires further investigation.     

Responses of hypothalamic neurons to stimulation of the vestibular nerve and lateral vestibular nucleus in the rabbit

Acute experiments were performed on rabbits to study the responses of neurons in the anterior, ventromedial, and posterior nuclei of the hypothalamus to single, paired, and rhythmic stimulation of the vestibular nerve and lateral vestibular nucleus of Deiters. The data obtained showed that neurons of the posterior nucleus of the hypothalamus were the most sensitive. Three types of response were seen from hypothalamic neurons, with short, long, and intermediate latent periods. This provides evidence that ascending afferent spike activity from the lateral vestibular nucleus of Deiters to the hypothalamus is mediated by mono-, oligo-, and polysynaptic pathways. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 83, No. 11-12, pp. 49–56, November–December, 1997.     

Antitumor effectiveness of different amounts of electrical charge in Ehrlich and fibrosarcoma Sa-37 tumors

Background

Tumor-associated antigens recognized by humoral effectors of the immune system are a very attractive target for human cancer diagnostics and therapy. Recent advances in molecular techniques have led to molecular definition of immunogenic tumor proteins based on their reactivity with autologous patient sera (SEREX).

Methods

Several high complexity phage-displayed cDNA libraries from breast carcinomas, human testis and breast carcinoma cell lines MCF-7, MDA-MB-468 were constructed. The cDNAs were expressed in the libraries as fusion to bacteriophage lambda protein D. Lambda-displayed libraries were efficiently screened with sera from patients with breast cancer.

Results

A panel of 21 clones representing 18 different antigens, including eight proteins of unknown function, was identified. Three of these antigens (T7-1, T11-3 and T11-9) were found to be overexpressed in tumors as compared to normal breast. A serological analysis of the 21 different antigens revealed a strong cancer-related profile for at least five clones (T6-2, T6-7, T7-1, T9-21 and T9-27).

Conclusions

Preliminary results indicate that patient serum reactivity against five of the antigens is associated with tumor disease. The novel T7-1 antigen, which is overexpressed in breast tumors and recognized specifically by breast cancer patient sera, is potentially useful in cancer diagnosis.     

Concomitant granulocyte colony-stimulating factor and induction chemoradiotherapy in adult acute lymphoblastic leukemia: a randomized phase III trial

This prospective multicenter study examined whether simultaneous administration of granulocyte colony-stimulating factor (G-CSF; Filgrastim) and induction chemotherapy for adult acute lymphoblastic leukemia (ALL) could prevent treatment-related neutropenia, infections, and resulting treatment delays. Seventy-six patients were randomly assigned to receive either G-CSF (n = 37) or no growth factor (n = 39) in conjunction with a uniform chemotherapy consisting of cyclophosphamide, cytarabine, mercaptopurine, intrathecal methotrexate, and cranial irradiation. The median duration of neutropenia (absolute neutrophil count < 1 x 10(9)/L) during chemotherapy was 8 days in patients receiving C-CSF, compared with 12.5 days in the control group (P < .002). A similar reduction from 11.5 to 7 days was observed in patients with T-ALL receiving additional mediastinal irradiation (P = .13). Infections occurred in 43% and 56% of patients in the G-CSF and control arm, respectively (P = .25); the incidence of nonviral infections was reduced by 50%, from 32 episodes in the control arm to 16 episodes in the G-CSF arm. Prolonged interruptions of chemotherapy administration were less frequent, with delays of 2 weeks or more occurring in only 24% of patients receiving G-CSF as opposed to 46% in the control arm (P = .01). Accordingly, chemotherapy was completed significantly earlier with the use of G-CSF (39 v 44 days, P = .008). With a median follow-up of 20 months, the probability of disease-free survival was 0.45 in the G-CSF group and 0.43 in the control group (P = .34). In conclusion, adult ALL patients appear to benefit by the simultaneous administration of G-CSF with induction chemotherapy because of a significant reduction in the duration of neutropenia, a trend to fewer infections, and a more rapid completion of chemotherapy.     

Should ‘smart phones’ be used for patient photography?

BACKGROUND:

Within the field of plastic surgery, clinical photography is an essential tool. ‘Smart phones’ are increasingly being used for photography in medical settings.

OBJECTIVE:

To determine the prevalence of smart phone use for clinical photography among plastic surgeons and plastic surgery residents in Canada.

METHODS:

In 2014, a survey was distributed to all members of the Canadian Society of Plastic Surgeons. The questions encompassed four main categories: smart phone use for clinical photos; storage of photos; consent process; and privacy issues. The survey participation rate was 27% (147 of 545) with 103 surgeons and 44 residents. In total, 89.1% (131 of 147) of respondents have taken photographs of patients using smart phones and 57% (74 of 130) store these photos on their phones. In addition, 73% (74 of 102) of respondents store these photos among personal photos. The majority of respondents (75% [106 of 142]) believe obtaining verbal consent before taking clinical photographs is sufficient to ensure privacy is respected. Written consent is not commonly obtained, but 83% (116 of 140) would obtain it, if it could be done more efficiently. Twenty-six percent (31 of 119) of respondents have accidentally shown a clinical photograph on their phone to friends or family. A smart phone application that incorporates a written consent process, and allows photos to be immediately stored externally, is perceived by 59% (83 of 140) to be a possible way to address these issues.

CONCLUSION:

Smart phones are commonly used to obtain clinical photographs in plastic surgery. There are issues around consent process, storage of photos and privacy that need to be addressed.     

The role of the specific and nonspecific afferent systems in the mechanism of changes in evoked cortical responses in the presence of vibration

The interrelationship of the activity of specific and nonspecific afferent systems in the mechanism of changes in the electrical activity of the cortex under the influence of vibration was studied under chronic experimental conditions. The character of the postvibrational shifts in the vestibulo- and reticulocortical evoked responses in the presence of the isolated and combined disengagement of the specific (vestibular) and nonspecific afferent systems of the brain was investigated. It was established that vestibular afferentation plays a significant role in the mechanism of postvibrational shifts in the vestibulocortical evoked responses, whereas nonspecific, as well as proprioceptive, somatic, and visceral as well as other inputs play the dominant role for the reticulocortical system of integration.Translated from Fiziologicheskii Zhurnal, Vol. 77, No. 5, pp. 18–25, May, 1991.     

The epidemiological profile of the Vascular Birthmark Clinic at the Alberta Children’s Hospital

BACKGROUND:

The Vascular Birthmark (VBM) Clinic at the Alberta Children’s Hospital (Calgary, Alberta) is a multidisciplinary clinic dedicated to the evaluation of children with vascular anomalies.

OBJECTIVE:

To review the characteristics of patients seen at the VBM Clinic.

METHOD:

A retrospective data analysis of all pediatric patients presenting to the VBM Clinic between 1998 and 2009 was performed. Data including demographic, referring, diagnostic and treatment information were obtained from the clinic’s database.

RESULTS:

Of 932 patients, 621 with hemangiomas and 311 patients with vascular malformations were found in the database. Hemangiomas were more commonly found in girls (68.5%), and most commonly located on the head and neck (54%), with most patients (72.6%) having only one lesion. Of the patients with hemangiomas, 14.7% underwent diagnostic imaging investigation and 23.7% received treatment including medications, surgery, pulsed-dye laser or dressings. The sex distribution among the 311 patients with vascular malformations was almost equal. Venous malformations accounted for 38.9% of patients, isolated capillary malformations for 31.5%, lymphatic malformations for 11.6%, mixed low-flow malformations for 14.8% and arteriovenous malformations for 2.9%. Overall, 37.9% of patients underwent diagnostic imaging investigation and 42.4% received treatment – either pulsed-dye laser, surgical excision, sclerotherapy or other treatment.

CONCLUSIONS:

Hemangiomas and vascular malformations can occur at any anatomical site. There is a large variation in clinical presentation necessitating expertise in a variety of diagnostic approaches and treatment modalities. Vascular anomalies are best managed in a multidisciplinary setting.