Antenatal Education for Cesarean Birth: Extension of a Field Test

An exploratory study was conducted to compare responses of vaginally delivered and cesarean-delivered parents to an antenatal educational program of cesarean birth information and to determine the feasibility of incorporating the educational program into Lamaze childbirth preparation classes. Fifty-eight pregnant women and 57 male partners received the educational program. Mailed questionnaires were returned by 44 women and 42 men, representing 13 of the 15 cesarean deliveries and 31 of the 43 vaginal deliveries experienced by class participants. Findings indicated that the educational program met most of the parents' information needs, regardless of method of delivery. Study results suggest that childbirth educators must continue to seek ways to prepare expectant parents for unanticipated cesarean birth without causing undue distress.     

Effect of dietary supplementation with n-3 fatty acids on clinical manifestations of psoriasis

In a double-blind, block randomized study we investigated the effect of dietary supplementation with eicosapentaenoic acid in patients with psoriasis. The experimental group received 10 g of fish oil daily containing approximately 1.8 g eicosapentaenoic acid, while the controls were given an isoenergetic amount of olive oil. We found no significant change in the clinical manifestations of psoriasis in either group after 8 weeks of treatment. In the experimental group, the amount of n-3 fatty acids in serum phospholipids was significantly increased at the end of trial as compared to pre-treatment values, whereas the level of n-6 fatty acids was decreased.     

A sign of symptomatic chronic cholecystitis on biliary scintigraphy

Five hundred patients with acute right-upper-quadrant pain underwent biliary scintigraphy with 99mTc paraisopropyliminodiacetic acid. One hundred and thirty-four studies were reported normal (both gallbladder and activity in bowel are noted in 1 hr). Of the 134 studies reported as normal, 32 showed intestinal activity before gallbladder visualization during the first hour of the study. Sonography and/or oral cholecystography revealed that 24 patients had gallstones, and eight patients had no demonstrable pathology in the biliary system. Of the 134 studies, 102 showed visualization of the gallbladder before intestinal activity during the first hour of the study. Sonography and/or oral cholecystography showed that 73 patients had normal biliary system. The remaining 29 patients had gallstones. The overall sensitivity of this finding is 45%, the specificity is 90%, and the accuracy is 73%. In this group of symptomatic patients, the appearance of intestinal activity before gallbladder activity on biliary scintigraphy warrants further evaluation of these patients by sonography and/or oral cholecystography.     

Glucocorticoids downregulate the vasopressin-regulated urea transporter in rat terminal inner medullary collecting ducts.

This study tested whether glucocorticoids regulate tubular urea transport. Urea permeability was measured in perfused inner medullary collecting duct (IMCD) subsegments from rats that underwent adrenalectomy, adrenalectomy plus replacement with a physiologic dose of glucocorticoid (dexamethasone), or sham operation. Compared with sham rats, basal urea permeability in terminal IMCD was significantly increased in adrenalectomized rats and reduced in dexamethasone-treated rats. Vasopressin significantly increased urea permeability in all three groups. In contrast, there was no difference in basal or vasopressin-stimulated urea permeability in initial IMCD between the three groups. Next, membrane and vesicle fraction proteins were isolated from inner medullary tip or base and Western analysis was performed by use of an antibody to the rat vasopressin-regulated urea transporter. Vasopressin-regulated urea transporter protein was significantly increased in both membrane and vesicle fractions from the inner medullary tip of adrenalectomized rats. There was no change in vasopressin-regulated urea transporter protein in the inner medullary base, and Northern analysis showed no change in urea transporter mRNA abundance in either inner medullary region. It was concluded that glucocorticoids can downregulate function and expression of the vasopressin-regulated urea transporter in rat terminal IMCD.     

Changing patterns in the humoral immune response to malaria before, during, and after the application of control measures: a longitudinal study in the West African savanna.

A longitudinal seroimmunological investigation of malaria was performed as part of the WHO research project conducted in the northern part of Nigeria from 1970 to 1975. The project included a preintervention phase, an intervention phase with application of malaria control measures (spraying of residual insecticide and mass drug administration), and a postintervention phase. Serological observations were made on the total population of eight villages consisting of approximately 3000 persons. Six immunological parameters were studied, namely, the serum levels of IgG and IgM, the number of bands of precipitation for Plasmodium falciparum in the double diffusion (Ouchterlony) test, the titres of antibodies for P. falciparum and P. malariae in the indirect fluorescent antibody (IFA) test, and the titres of agglutinating antibodies for P. falciparum by the indirect (passive) haemagglutination (IHA) test. The serological results were used to evaluate the impact on the humoral immune response of different levels of parasitaemia resulting, in the unprotected population, from natural factors such as seasons and ageing and in the protected population, from human intervention through the application of control measures and their interruption. The linkage by computer processing of the longitudinal data allowed analysis of the relationship between the results of a serological test in the same person at different surveys, and analysis of correlation between serological results and the concurrent parasitological findings. The correlation between parasitaemia and the results of the different serological tests at the same survey in the same person were also examined and analysed in terms of sensitivity and specificity of the tests.