Outcome of Pregnancy in an Oxford-Cardiff Cohort of Women with Previous Bacteriuria

To investigate the influence of asymptomatic bacteriuria inchildhood on subsequent pregnancy, we reviewed the outcome of139 pregnancies in 88 women who were first identified duringa programme of screening schoolgirls for asymptomatic bacteriuriacarried out between 1970–1972 [1]. Data were analysedfor the following groups: 50 pregnancies in 28 women with knownrenal scars (group 1); 16 pregnancies in 14 women with normalkidneys and reflux (group 2); 73 pregnancies in 46 women withnormal urinary tracts (group 3); 139 healthy controls. Women in group 1 had a 3.3-fold increased relative risk of hypertension(p < 0.01) and a 7.6-fold increased risk of pre-eclampsia(p< 0.05) compared to controls, and a higher rate of obstetricinterventions, including emergency caesarean section. Womenin groups 2 and 3 appeared to carry a slightly increased riskof hypertension during the last trimester (RR = 1.8) but therewere no significant differences in this or the incidence ofpre-eclampsia or mode of delivery. Bacteriuria was more prevalentin all index groups compared to controls (37 per cent vs. 8per cent, p < 0.01) and included four cases of acute pyelonephritisin the study group. Fetal outcome was satisfactory in all cases.These results suggest that women with renal scars are at riskof hypertension and pre-eclampsia during pregnancy but thatmodern obstetric care minimizes these risks.     

Increased hunger and thirst during glucoprivation in humans

Five male volunteers received two intravenous infusions of 2-deoxy-D-glucose (2DG) and one of normal saline. Hunger and thirst ratings, solid-food and water intake, and plasma epinephrine and glucose levels were greater after both of the 2DG infusions than after the saline infusion. This study suggests that the increase in water intake caused by 2DG does not depend on elevated hunger, and demonstrates that increased caloric intake after 2DG infusions is not dependent on greater thirst. Behavioral and adrenomedullary responses to both 2DG infusions were qualitatively and quantitatively the same, suggesting that there are no residual effects of 2DG that diminish the ability of the subjects to respond to glucoprivation. Measurements of possible thirst stimuli revealed no clear mechanism for the dipsogenic effect of 2DG.     

Effects of oleic acid and oxygen restriction followed by re-oxygenation on rhythm and contractile activity of the isolated rat heart; protective action of glucose

Isolated rat hearts beating intrinsic rhythm were perfused with balanced salt solution containing 0.15 mm albumin and glucose (11 mm) or oleic acid (FFA/albumin molar ratio 2.65–4.65). After a control period (30 min) oxygen supply was restricted by lowering pO₂ from 700 to 140 mm Hg. After 20 min of oxygen restriction oxygenation was resumed. In all hearts coronary flow increased substantially during oxygen restriction and returned to approximately pre-restriction levels after reoxygenation. Contraction amplitude decreased during oxygen restriction and re-established itself only party after resuming oxygenation. Decrease was significantly greater and recovery significantly less in hearts perfused with oleic acid. Ventricular pre-mature beats (VPBs) were significantly more numerous in oleic acid hearts and occurred mainly shortly after starting reoxygenation. The incidence of other ventricular arrhythmias was also greater in these hearts. In hearts perfused with the combination oleic acid (FFA/albumin molar ratio 4.65) and glucose (11 mm) incidence of VPBs was significantly lower and CA was much less depressed than in hearts perfused with oleic acid only. Apparently glucose protects the heart from the deleterious effects of oleic acid and oxygen restriction. Pyruvate (11 mm) showed no protecting action in this respect. The difference in electrical and contractile behaviour between oxygen restricted hearts perfused with oleic acid and those perfused with glucose was even more striking when the hearts were paced (5/s) instead of beating intrinsic rhythm.