Satisfaction and use of a spiritually based mantram intervention for childbirth-related fears in couples

This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.     

Manual vacuum aspiration: a safe alternative for the surgical management of early pregnancy loss

Manual vacuum aspiration (MVA) is an alternative to the standard surgical curettage, performed under local anaesthetic in the setting of a treatment room. The aim of our study was to assess the efficacy of MVA in the management of first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. This was a retrospective study of 246 patients who were scheduled to undergo MVA for first trimester early fetal demise and first- and mid-trimester incomplete miscarriage. One woman was excluded in the analysis because of the procedure being abandoned prior to MVA. Efficacy of the procedure was 94.7% (232/245). Incomplete uterine evacuation was seen in 5.3% (13/245) patients. Although not widely used in the UK, MVA could be considered routinely, thus avoiding general anaesthesia and the need for access to theatre.     

Possible impact of inflammatory status on C‐telopeptide pyridinoline cross‐links of Type I collagen and osteocalcin levels around oral implants with peri‐implantitis: a controlled clinical trial

Summary Detection of progression level of peri‐implantitis may help in the prevention of oral implant failure. C‐telopeptide pyridinoline crosslinks of Type I collagen (ICTP) and osteocalcin (OC) are specific markers of bone turnover and bone degradation. Determination of the ICTP and OC levels in the peri‐implant sulcus fluid (PISF) may predict the metabolic and/or inflammatory changes in the peri‐implant bone. The aim of this clinical study was to evaluate ICTP and OC levels in the PISF for oral implants with and without peri‐implant bone destruction and correlate these levels with the traditional clinical peri‐implant parameters (probing depth, plaque index, gingival index and gingival bleeding time index) and radiographic bone level measurements. Fifteen patients with 30 peri‐implant sites with bone destruction (radiographic bone loss) and health were included. Clinical parameters were measured and PISF was collected from the sites. Peri‐implant sulcus fluid ICTP and OC levels were detected by radioimmunoassay technique from PISF samples. All clinical parameters demonstrated a significant increase in peri‐implantitis sites compared with healthy sites. The PISF volume of the peri‐implantitis sites was also significantly higher than of the healthy peri‐implant sites. Although not statistically significant, a trend of increase was demonstrated in ICTP PISF samples sampled from peri‐implantitis sites compared with healthy sites. A significant increase was noticed for OC PISF level in peri‐implantitis sites compared with healthy ones. As well as peri‐implant clinical measurements, volumetric changes at PISF may be counted as an important clinical parameter to distinguish the bone destruction sites from healthy sites around oral implants.     

Sweets, snacking habits, and skipping meals in children and adolescents on intensive insulin treatment

Aim:  To examine the association between skipping meals and snacking events and dietary and clinical characteristics in children and adolescents using modern insulin treatment.
Methods:  Dietary intake was recorded for 4 d in food diaries in 655 young diabetic patients. Number of meals and snacking events was recorded in a separated questionnaire, while clinical data were obtained from case record forms. Skipping meals refer to consuming a main meal (e.g., breakfast) five times a week or less.
Results:  Modern insulin treatment may favor a more flexible lifestyle. This study shows that there are fewer young diabetic patients who skip meals than non-diabetic controls (p < 0.001) even when using modern intensified insulin treatment. However, skipping meals among young diabetic patients was associated with negative characteristics such as having suboptimal hemoglobin A1c (HbA1c) (OR 4.7, p = 0.02), higher low-density lipoprotein (LDL) cholesterol levels (OR 4.0, p < 0.001), watching more TV (OR 3.6, p < 0.001), being overweight (OR 2.8, p = 0.03), as well as having a higher intake of added sugar (OR 2.1, p = 0.01) and lower intake of fiber (OR 0.2, p = 0.04) compared with those not skipping meals. Having more than two snacking events during the day was associated with higher HbA1c, higher intake of added sugar and sweets, and spending more hours in front of the TV or personal computer.
Conclusions:  In general, fewer children and adolescents with type 1 diabetes skip meals compared with healthy peers. Those who skip meals and have more snacking events have poorer glycemic control and less healthy dietary and leisure habits.     

Tyrphostin AG34对重组人蛋白激酶CK2全酶的影响

目的 :观察TyrphostinAG34对重组人蛋白激酶CK2全酶的直接作用及其酶动力学机制。 方法 :利用基因工程克隆、表达和纯化获得重组人蛋白激酶CK2α和 β亚基 ,在体外等摩尔数混合构成有最大生物活性的重组CK2全酶 ,在不同条件下测定CK2的活性。CK2活性通过测定转移到CK2底物上的 [γ 32 P]ATP或 [γ 32 P]GTP的 [32 P]放射活度来检测。结果 :重组人CK2是一种Ca2 + 、cAMP和cGMP等第二信使非依赖性蛋白激酶 ,与天然CK2的性质一致。AG34对重组人CK2全酶具有很强的抑制作用 ,IC50 为 1.0 μmol·L 1,抑制作用远大于CK2已知抑制剂 5 ,6 -二氯 1 β 呋喃糖苯并咪唑 (DRB)和N (2 氨乙基 ) 5 氯萘 1 硫胺 (A3)。AG34对重组人CK2的动力学研究表明 :它与GTP呈现以竞争性为主的混合型抑制作用 ,与酪蛋白呈非竞争性抑制作用。结论 :AG34不仅是酪氨酸蛋白激酶的抑制剂 ,而且是一种十分有效的蛋白激酶CK2的抑制剂 .重组人蛋白激酶CK2可作为一种较为简便筛选和开发有效的CK2抑制剂的分子靶点。     

Pipobroman therapy of polycythemia vera

Between 1971 and 1981, 74 patients with polycythemia vera were treated with pipobroman using a high-dose induction, low-dose maintenance regimen. Complete remission was achieved in 51 of 54 previously untreated patients (94.4%) and in 17 of 20 patients (85%) previously treated wih radioactive phosphorus (32 p) and busulfan. The earliest modifications were noted on day 16, and on the average, blood counts were normal by day 45. Thirty percent of the patients relapsed, the mean duration of the remission being 17.5 mo. Following recurrence pipobroman was consistently effective in the same doses but the mean duration of the next remissions was 10 mo. Transient leukopenia and thrombocytopenia occurred in 8% and 7% of patients, respectively, during initial phase, and anemia was noted in 3 patients. Macrocytosis was noted in 20% of patients during maintenance phase. Three cases of acute leukemia and 3 cases of osteomyelosclerosis were recorded, all occurring in patients who had previously received 32 p and/or busulfan. No hematologic malignancies were seen among patients treated with pipobroman alone; follow-up exceeded 6 yr for 20 patients and the median follow-up period was 3.6 yr. Pipobroman appears safer than other alkylating agents; it is as effective as 32 p and works more quickly. Longer follow-up will be required to evaluate the drug's oncogenic potential, which is still not known.     

Leptomeningeal metastasis: MR imaging

Seven patients with central nervous system neoplasia and leptomeningeal metastases, proved either at initial diagnosis or on follow-up with contrast material-enhanced computed tomography (CT), were evaluated with magnetic resonance (MR) imaging. In two patients, diffuse sulcal enhancement on CT scans was inapparent on T1- or T2-weighted MR images. Likewise, in four patients diffuse cisternal enhancement on CT scans was not identifiable with MR. Nodular or focal cisternal masses were identified with both CT and MR imaging in three patients; in two, however, MR imaging provided less information. Ependymal and subependymal metastases identified with CT (two patients) were indistinguishable on MR images from periventricular abnormalities of radiation therapy and/or hydrocephalus. These findings suggest that leptomeningeal metastasis may be so subtle or inapparent as to be overlooked with MR imaging alone. Thus, CT and MR imaging should be considered complementary techniques for initial diagnosis and follow-up of tumors with a propensity for leptomeningeal metastasis.     

Socioeconomic status and determinants of hemostatic function in healthy women

Hemostatic factors are reported to be associated with coronary heart disease (CHD). Socioeconomic status (SES) is 1 of the determinants of the hemostatic profile, but the factors underlying this association are not well known. Our aim was to examine determinants of the socioeconomic differences in hemostatic profile. Between 1991 and 1994, we studied 300 healthy women, aged 30 to 65 years, who were representative of women living in the greater Stockholm area. Fibrinogen, factor VII mass concentration (FVII:Ag), activated factor VII (FVIIa), von Willebrand factor (vWF), and plasminogen activator inhibitor-1 (PAI-1) were measured. Educational attainment was used as a measure of SES. Low educational level and an unfavorable hemostatic profile were both associated with older age, unhealthful life style, psychosocial stress, atherogenic biochemical factors, and hypertension. Levels of hemostatic factors increased with lower educational attainment. Independently of age, the differences between the lowest (mandatory) and highest (college/university) education in FVII:Ag levels were 41 microg/L (95% confidence interval [CI], 15 to 66 microg/L, P=0.001), 0.26 g/L (95% CI, 0.10 to 0.42 g/L, P=0.001) in fibrinogen levels, and 0.11 U/mL (95% CI, 0.09 to 0.12 U/mL, P=0.03) in levels of vWF. The corresponding differences in FVIIa and PAI-1 were not statistically significant. With further adjustment for menopausal status, family history of CHD, marital status, psychosocial stress, lifestyle patterns, biochemical factors, and hypertension, statistically significant differences between mandatory and college/university education were observed in FVII:Ag (difference=34 microg/L; 95% CI, 2 to 65 microg/L, P=0.05) but not in fibrinogen (difference=0.03 g/L; 95% CI, -0.13 to 0.19 g/L, P=0.92) or in vWF (difference=0.06 U/mL; 95% CI, -0.10 to 0.22 U/mL, P=0.45). An educational gradient was most consistent and statistically significant for FVII:Ag, fibrinogen, and vWF. Age, psychosocial stress, unhealthful life style, atherogenic biochemical factors, and hypertension mediated the association of low educational level with elevated levels of fibrinogen and vWF. Psychosocial stress and unhealthful life style were the most important contributing factors. There was an independent association between education and FVII:Ag, which could not be explained by any of these factors.