Prevalence of drug use during pregnancy: a pharmacoepidemiological approach

INTRODUCTION: Few Brazilian papers on the use of medication in pregnancy have been found in the indexed medical literature. This paper describes the use of medication during pregnancy among women who gave birth in a teaching maternity hospital in the city of Campinas, Brazil. METHODS: A retrospective study on the pattern of drug use during pregnancy was conducted among 1,000 mothers who were interviewed using a structured questionnaire after delivery, while they were still in hospital. The following parameters were registered: sociodemographic characteristics, obstetric and contraceptive history, data on prenatal care and medications used during pregnancy. Statistical analysis was performed using ANOVA and chi-square test at p = 0.05. RESULTS: Among the interviewed patients, 94.6% had taken at least one medication during pregnancy, and 46.1% had used medication in the first trimester. Of 3,778 medications reported, 88.8% had been prescribed by a doctor. The median of medications taken was 3 (ranging from 0 to 18). The six most used classes of medications were: analgesics, spasmolytics, gynecological antiinfectious agents, antianemics, antacids and systemic antibiotics. The five most used medications were: butyl scopolamine, ferrous sulfate, dipirone, nistatin and multivitamin tablets. Only 27.7% of the patients had been alerted to the risk of taking medication during pregnancy. CONCLUSION: Knowing the profile of medications used during pregnancy may help devising programs to provide information to the patients and continuing education to health care professionals.     

Concentrations and enantiomer fractions of organochlorine compounds in Baltic species hit by reproductive impairment

Concentrations and enantiomer fractions (EFs) of organochlorine compounds (OCs) were determined in tissues of gray seal (Halichoerus grypus) and salmon (Salmo salar) originating from the Baltic Sea. The selected seal specimens ranged from starved to unstarved animals, and some of them suffered from a disease complex, while the salmon samples originated from individuals, which were known to produce offspring with and without the M74 syndrome. Significant differences in residue levels and EFs were found between seal groups but not between M74 salmon and non-M74 salmon. The relations between chemical and biological variables of seal samples were investigated with multivariate statistics. Poor health status correlated strongly with age, while bad nutrition condition was associated mainly with high pollution loads and distinctively nonracemic chiral OC compositions. High biotransformation rate (as indicated by fraction of chlordane metabolites in relation to total level of chlordanes) was also associated with large deviations from racemic values and high contaminant levels.     

黄芪健胃汤治疗消化性溃疡120例

消化性溃疡是一种常见病，具有病程长、易于发作、迁延难愈的特点。笔者自1998年以来，用自拟黄芪健胃汤治疗120例，并以同期西药治疗的90例为对照组进行对比观察，疗效满意，现报道如下。     

Increased blood-brain barrier permeability of morphine in a patient with severe brain lesions as determined by microdialysis

Intracerebral microdialysis was utilised to obtain information regarding how morphine is transported across the blood-brain barrier (BBB). In a patient with a severe brain injury, we measured simultaneously unbound extracellular fluid (ECF) concentrations of morphine in human brain and in subcutaneous fat tissue, which were compared to morphine levels in arterial blood. This report shows an increase in morphine levels near the trauma site in the brain compared to uninjured brain tissue. The half-life of morphine in uninjured and injured brain tissue of 178 min and 169 min, respectively, were comparable but were longer than in blood (64 min) and adipose tissue (63 min). This indicates that morphine is retained in brain tissue for a longer time than what could be expected from the blood concentration-time profile. These results show the potential of the microdialysis technique in providing new information regarding the pharmacokinetics of drug in the human brain close to the trauma site and in macroscopically intact tissue.     

Social differences in Swedish infant mortality by cause of death, 1983 to 1986.

OBJECTIVE. We sought to investigate social differences in Swedish infant mortality by cause of death. METHODS. All live single births in Sweden between 1983 and 1986 to mothers 15 to 44 years old with Nordic citizenship were studied. The causes of death were classified into six major groups. Mother''s education was used as a social indicator. Logistic regression analysis was used with identical models for all groups of causes of death. RESULTS. There were 355,601 births and 2012 infant deaths. Only for sudden infant death syndrome were significant social differences found, with crude odds ratios of 2.6 for mothers with less than 10 years of education and of 1.9 for mothers with 10 to 11 years, compared with 1.0 for mothers with 15 years or more. After adjusting for age, parity, and smoking habits, these ratios were no longer significant. CONCLUSIONS. The social differences obtained could be explained by the fact that mothers with less education smoke more, are younger, and have higher parity than those with more education.     

Endothelial dysfunction after exposure to cobalt chloride enhanced vascular contractility

Brief exposure to cobalt chloride augmented vascular contractility. We hypothesized that endothelial dysfunction plays a role in the augmentation of aortic contractility, after brief exposure to cobalt chloride. Rat aortic ring preparations were mounted in organ baths, exposed to cobalt chloride (0.3-300μmol/L) for 30min, and then subjected to contractile agents or relaxants 1 and 5h after the end of exposure. Presence of cobalt chloride did not affect the contractile response to phenylephrine. Brief exposure to cobalt chloride, however, even at 5h after the end of exposure, not only augmented contractile responses to KCl or phenylephrine but also attenuated the relaxant response to acetylcholine. The mechanical denudation of endothelium or inhibition of endothelial nitric oxide synthase with 100μmol/L N(ω)-nitro-l-arginine methyl ester abolished the augmentation of contractile responses. Pre-treatment with 150units/mL of superoxide dismutase also abrogated the augmented contractile responses. Brief exposure to cobalt chloride did not affect the contractile response to phorbol dibutyrate in the presence or absence of calcium, or the expression of HSP70. In conclusion, endothelial dysfunction plays an important role in the augmentation of aortic contractility, after brief exposure to cobalt chloride.