Influence of site of obstetric care and delivery on pregnancy management and outcome

A retrospective cohort study of 863 pregnancies cared for by family physicians at three sites--rural-rural (RR), rural-urban (RU), and urban-urban (UU)--was designed to test the hypothesis that ready on-site access to perinatal subspecialists would improve pregnancy outcome. No differences in delivery type, length of gestation, birth weight, or nursery care were found. An Apgar score of less than 7 at 1 minute or less than 8 at 5 minutes was 2.17 and 2.31 times more likely at RU and 2.48 and 2.60 times more likely at UU, respectively, than at RR. The overall Cesarean section rate was 9.6 percent, forceps rate was 7.2 percent, and nonroutine nursery care rate was 7.9 percent. Neonatal and perinatal mortality rates were 3.5 and 4.6 per 1,000 live births. There is no evidence that on-site perinatal subspecialists improve perinatal outcome when care is provided by board-certified family physicians. Small obstetric centers provide quality perinatal care with outcome dependent on physician's skill rather than on technology.     

Analysis of the degree of precision of a computer-assisted dietary survey method

A computer-assisted method for the registration of food intakes in real time according to a concise and simple procedure was subjected to a series of controls in order to assess precision. The method employs the 'portion' of a composite dish as unit of measure. The constancy of the portion was tested. The results show that the recipes of the diet of a subject may be stored and utilized in deferred time without loss of precision: data to be recorded in real time are then very limited. The length of period of analysis was also studied. The time of investigation should not be shorter than two weeks to obtain precise information on the feeding habits of an individual subject, whereas for a group of subjects the diary of a single day provides information of sufficient precision.     

The relationship between intestinal Campylobacter species isolated from animals and humans as determined by BRENDA

Intestinal thermophilic Campylobacter species produce stable patterns when subjected to bacterial restriction endonuclease DNA analysis (BRENDA); this technique is therefore of considerable value in epidemiological studies. BRENDA was used to examine thermophilic Campylobacter species from humans, wild and domestic animals. One hundred and ninety-four (61%) of 316 isolates of Campylobacter jejuni from humans had BRENDA patterns which could be matched to those of animal isolates. Poultry appear to be a major source of infection for C. jejuni in humans with nearly half (49.7%) of the human isolates giving patterns which were indistinguishable from those isolated from poultry. A total of 60 BRENDA types were identified from 316 human isolates and 11 of these had the same pattern as those isolated from poultry. One of the three Campylobacter coli BRENDA types recovered from poultry was indistinguishable from a human isolate type. Pigs appear to be only a minor source of C. coli infection for humans in New Zealand. Rats were found to be infected with strains of C. jejuni with BRENDA patterns indistinguishable from those infecting humans, poultry and a horse. None of the 102 isolates of Campylobacter species from wild birds gave BRENDA patterns similar to those of isolates from humans.     

Metabolic response to beet fibre test meals

Test meals with 10.9 g dietary fibre from sugar beet and corresponding control meals were given to eight healthy subjects, aged 67 ± 9 years. The postprandial glucose, triglyceride, hormone and glycerol responses were monitored during 3 hours. After the beet fibre meal the insulin and C-peptide areas were reduced by 28 ( P < 0.01) and 22% ( P > 0.025), respectively, and the somatostatin levels increased by approximately 30% ( P > 0.05). Further, the maximum relative postprandial reduction of plasma glycerol levels was less evident after the fibre-rich meal than after the control meal (36 ± 4% v. 46 ± 4%, P < 0.05). There was no apparent difference in the overall glycaemic response between the meals. The triglyceride levels were similar after both test meals.
Suspension of beet fibre bread given to rats by oro-gastric intubation induced lower blood glucose response than a control bread at 15 and 30 min ( P < 0.001), respectively, but a similar insulin response.
The results suggest an effect of beet fibre on the rate of carbohydrate absorption, expressed as a lower insulin response in the healthy volunteers and a reduced glucose response in the rat.
The mechanism behind this effect in healthy subjects could possibly be mediated by an increased somatostatin response.     

Hybridization of Aedes (protomacleaya) zoosophus with Ae. (Pro.) triseriatus group species: hybrid morphology

Morphology of hybrids between Aedes (Protomacleaya) zoosophus and Ae. (Pro.) triseriatus group species is described. Adult females of hybrids key to Ae. zoosophus. Hybrids are differentiated from Ae. zoosophus by the dark longitudinal medial or submedial lines on the thorax and by the reduced width of the light tarsal and abdominal bands. The transverse band of light scales on the anterior scutum is complete in Ae. hendersoni/Ae. zoosophus hybrids and incomplete in Ae. triseriatus/Ae. zoosophus hybrids. Aedes brelandi/Ae. zoosophus hybrids are similar to Ae. hendersoni/Ae. zoosophus hybrids. However, due to the allopatric distributions of Ae. brelandi and Ae. zoosophus, such hybrids are not expected.     

Immunopathologic study of Vogt-Koyanagi-Harada syndrome

We studied an enucleated eye from a patient with a 30-year history of Vogt-Koyanagi-Harada syndrome using both conventional and immunohistochemical techniques. Clinically, the eye was in the end stage of Vogt-Koyanagi-Harada syndrome, and was characterized by the absence of inflammation, large areas of chorioretinal scarring, and pigmentary changes. Histopathologic examination showed marked retinal gliosis, extensive chorioretinal adhesion and scar formation, migration of pigment into the retina, and severe retinal pigment epithelial changes. However, foci of mild to moderate nongranulomatous inflammation of the uvea were observed. These foci contained infiltrating cells that were mainly T lymphocytes with B lymphocyte aggregates at the center. Scattered macrophages were also noted in the uvea and retina. These findings suggest that both the cell-mediated and humoral immune arms may play roles in the pathogenesis of Vogt-Koyanagi-Harada syndrome.     

钙拮抗剂TMB-8抑制BHQ,NE和KCl引起的培养乳牛基底动脉单个平滑肌细胞内游离钙的升高

用AR CM MIC阳离子测定系统,测量单个细胞内游离钙浓度([Ca²⁺]i),研究8-(N,N-二乙胺)-n-辛基 3,4,5-三甲氧基苯甲酸酯(TMB-8)对培养乳牛基底动脉平滑肌[Ca²⁺]i的作用。在细胞外钙浓度为1.3mmol·L^-1时,TMB-8(30μmol·L^-1)可明显抑制BHQ,NE及KCl引起[Ca²⁺]i的升高。在细胞外钙为零+EGTA 0.1mmol·L^-1时,TMB-8(10,30及100μmol·L^-1)可浓度依赖性地降低静息[Ca²⁺]i,TMB-8(30μmol·L^-1)可几乎完全阻断BHQ及NE引起[Ca²⁺]i的增加。研究表明TMB-8降低培养乳牛基底动脉平滑肌[Ca²⁺]i的机制,主要是抑制肌浆网Ca²⁺的释放,或增加肌浆网对Ca²⁺的摄入,并由此间接地抑制细胞外钙的内流。     

Impact of a Pharmacist-Based Consult Service on Nutritional Rehabilitation of Nonambulatory Patients with Severe Developmental Disabilities

A pharmacist consult service was developed to evaluate the appropriateness of enteral feeding through a permanent ostomy in 24 nonambulatory patients with severe developmental disabilities. Several problems with enteral nutrition were identified. Policies to improve them were instituted, and several educational presentations were made. Pharmacists' actions were implemented, including assessment of energy needs by indirect calorimetry and rearrangement of enteral feeding schedules to achieve optimal nutrition support and pharmacotherapy administration. By the fourth month of the consult service, body weight in these patients increased from 101 ± 6% of baseline to 109 ± 7% (p<0.05). Weight continued to increase through the seventh month of the consult service to 116 ± 12% of baseline (p<0.0001). Measured resting energy expenditure for the group was 889 ± 170 kcal/day compared with the predicted 1055 ± 163 kcal/day.     

Synthesis and Antitumour Activity of New Derivatives of Flavone-8-acetic Acid (FAA). Part 2: Ring-Substituted Derivatives

A range of 18 derivatives of flavone-8-acetic acid (FAA) with substituents on the 2-phenyl group have been prepared and their anti-tumour activity evaluated in vitro against a panel of human and murine tumour cell lines and in vivo against MAC 15A. There was no clear-cut relationship between in vitro and in vivo activity but the activity in each situation was found to be very sensitive to the precise substitution pattern with closely related isomers giving widely different activities. Some of the compounds, notably 10b,cj , and r , were active in vivo and these require further studies in order to evaluate their potential for development.