Ionic calcium and magnesium from pharmaceutical product BEROCCA effects on neuromuscular excitability

The important physiological role of calcium and magnesium ions is all over recognised, about a lot of enzymatic reactions. Magnesium deficit produce neuromuscular hyper-reactivity, psychic reactions, functional hypoparathyroidism, increase of K+ channels membranes permeability, while hypermagnesemia decrease Ach release from neuromuscular synapsis, with post-synaptic excitability decreasing. Using BEROCCA (Hoffman la Roche) 1 cp/day, 30 days at the teenagers with behaviour troubles and at a goup of pregnant women (trimester I-III) with paresthesia, irritability, sleeplessness, we observed an improve of clinical signs, increasing plasma Ca2+ and Mg2+. EEG and EMG prove the beneficial effects of pharmaceutical product BEROCCA.     

Extended use of a progesterone-releasing vaginal ring in nursing women: a phase II clinical trial

AIM: This study evaluates the performance of extended use of a progesterone (P)-releasing vaginal ring (PVR) in nursing women. METHOD: An open-label, noncomparative study on the safety and contraceptive efficacy of PVR replaced every 4 months of use (instead of 3 months) in 192 PVR acceptors. PVR use was initiated at day 59+/-2 (mean+/-SD) postpartum and continued until weaning or completing the use of three PVRs. RESULTS: Plasma P levels attained with the ring decreased from 17+/-1 to 14+/-1 nmol/L (mean+/-SE) from the third to the fourth month of use. These levels are still over the critical level of 10 nmol/L required for contraceptive protection. One pregnancy occurred in the third month of use of the second ring in 1998 woman-months of exposure. Extended use of the ring did not appear to affect breast-feeding performance or the rate of infant growth, and lactational amenorrhea was prolonged. No differences in the characteristics of bleeding between the third and fourth month of ring use were observed. CONCLUSION: The results indicate that use of the PVR for 4 months represents a safe and effective contraceptive for nursing women.     

Colonoscopy in Romania

BACKGROUND: To date, colonoscopy is considered the gold standard for the investigation of the colon and also the gold standard method for colorectal cancer screening. AIM of this paper was to assess if and how is Romania prepared to cope with screening of colon cancer by means of colonoscopy. METHOD: We sent a study-type questionnaire addressed to all the centers in Romania known to perform digestive endoscopy and we inquired about the total number of colonoscopies and flexible sigmoidoscopies performed in 2003 (the questionnaire was sent to 43 centers). RESULTS: Thirty-eight centers responded to the question-naire. The total number of colonoscopies performed in Romania in 2003, obtained by collecting the data from the study centers, was 22,324. The number of sigmoidoscopies performed during the same period was 12,349. The ratio between the number of colonoscopies and sigmoidoscopies was 1.8/1. There were 106.3 colonoscopies /100,000 inhabitants. CONCLUSION: Considering the population of Romania (about 21 million inhabitants), the number of colonoscopies performed is insufficient for our country. The number of centers performing colonoscopy in Romania is also insufficient.     

Spontaneous regression of residual low-grade cerebellar pilocytic astrocytomas in children

Background: Cerebellar low-grade astrocytomas (CLGAs) of childhood are benign tumours and are usually curable by surgical resection alone or combined with adjuvant radiotherapy. Objective: To undertake a retrospective study of our children with CLGA to determine the optimum schedule for surveillance imaging following initial surgery. In this report we describe the phenomenon of spontaneous regression of residual tumour and discuss its prognostic significance regarding future imaging. Materials and methods: A retrospective review was conducted of children treated for histologically proven CLGA at Great Ormond Street Hospital from 1988 to 1998. Results: Of 83 children with CLGA identified, 13 (15.7%) had incomplete resections. Two children with large residual tumours associated with persistent symptoms underwent additional treatment. Eleven children were followed by surveillance imaging alone for a mean of 6.83 years (range 2–13.25 years). Spontaneous tumour regression was seen in 5 (45.5%) of the 11 children. There were no differences in age, gender, symptomatology, histological grade or Ki-67 fractions between those with spontaneous tumour regression and those with progression. There was a non-significant trend that larger volume residual tumours progressed. Conclusions: Residual tumour followed by surveillance imaging may either regress or progress. For children with residual disease we recommend surveillance imaging every 6 months for the first 2 years, every year for years 3, 4 and 5, then every second year if residual tumour is still present 5 years after initial surgery. This would detect not only progressive or recurrent disease, but also spontaneous regression which can occur later than disease progression.     

Successful pregnancy and delivery after delaying the initiation of progesterone supplementation in a postmenopausal donor oocyte recipient

Progesterone luteal support has become a standard procedure during IVF cycles. Donor egg cycle women without inherent ovarian function require complete hormone replacement, in contrast with women undergoing IVF in which luteal support is used to supplement endogenous progesterone production. Progesterone support is clearly beneficial, although the timing of its initiation can affect overall outcomes. This paper describes a case in which a postmenopausal woman attending for oocyte donation did not receive her first progesterone injection at the correct time. Treatment with progesterone began when she arrived for the transfer of the donor embryos. The two embryos were maintained in culture and one was transferred on day 6 when the delayed progesterone administration had induced a secretory transformation in her endometrium. A single gestation sac was recorded 8 weeks later, and a healthy baby was subsequently born. On the morning of day 6, delayed progesterone supplementation had induced the secretory endometrial transformation typical of the second phase of the menstrual cycle.     

Influence of superstructure materials on strain around an implant under 2 loading conditions: a technical investigation

PURPOSE: This investigation was concerned with the effect of 3 superstructure materials on the strain around an implant under static and nonimpact dynamic loading. MATERIALS AND METHODS: Five highly filled composite resin-veneered crown analogs, 5 autopolymerized acrylic resin-veneered crown analogs, and 5 gold-alloy full cast crown analogs were prepared. The resin veneers were applied to gold-alloy frameworks. These crown analogs were prepared to fit an ITI implant-abutment assembly, which was screwed into a block of acrylic resin to simulate implantation in bone. The crown analogs were successively placed on the abutment, and a lateral load of 100 N was applied to the superstructure by a lever-type testing machine. Strains were recorded under static and dynamic loading by a 2mm-long strain gauge bonded to the surface of the bone simulant tangential to the implant. The dynamic load simulated masticatory cycles (75 strokes/min). RESULTS: Although the strain values differed significantly between the static and dynamic loading (P < .05), there was no significant difference among the superstructure materials under either loading condition (P > .05). DISCUSSION: These findings are in agreement with in vivo measurements, thus suggesting that cyclic rather than impact loading should be used in the investigation of occlusal material behavior under functional loading. CONCLUSION: Under static and nonimpact dynamic loading, the 3 superstructure materials tested (highly filled composite resin, acrylic resin, and gold alloy) had the same influence on the strain transmitted to a bone simulant that surrounded a single implant.     

Transmission of parentally shared human leukocyte antigen alleles and the risk of preterm delivery

OBJECTIVE: Our objective was to examine our hypothesis that the transmission of parentally shared human leukocyte antigen (HLA) alleles to offspring increases the risk of preterm delivery. METHODS: A population-based family study with participating children and their parents was conducted in Kaiser Permanente Medical Care Program, an integrated healthcare delivery system, in the Northern California Region. A total of 234 participants from 78 families with early preterm deliveries (35 weeks of gestation or greater) and 60 participants from 20 families with full-term births were included in the study. Buccal cells were collected from the first-born preterm cases and their parents to determine HLA-B (class I) and DRB1 (class II) types and the transmission of parental alleles to the offspring. The buccal samples were also collected from full-term deliveries to rule out possible segregation distortion at the studied HLA loci. RESULTS: Compared with the expected transmission probability based on Mendel's laws (25%), transmission of parentally shared HLA-B or DRB1 alleles from both heterozygous parents to offspring (48% of 23 heterozygous parents) was associated with a more than 5-fold increased risk of preterm delivery (odds ratio 5.5; 95% confidence interval 1.2-51). Transmission of parentally shared HLA alleles from heterozygous mothers (83%) appears to be more important in the etiology of preterm delivery than transmission from fathers (57%). The transmission pattern of parentally shared HLA alleles in our full-term controls was almost identical to the expected pattern based on Mendel's laws and demonstrated no segregation distortion at those HLA loci. CONCLUSION: Our findings provide evidence that the transmission of parentally shared HLA alleles may be an underlying mechanism for preterm delivery.     

Magnitude and impact of treatment delays on weeknights and weekends in patients undergoing primary angioplasty for acute myocardial infarction (the cadillac trial)

In 2,082 patients in the CADILLAC trial, the outcomes of patients presenting during peak hours were compared with those presenting during peak hours (Monday to Friday 8a.m. to 8 p.m., n = 1,047, 51%) were compared with those of patients presenting during off-peak hours (weeknights from 8 p.m. to 8 a.m. and weekends, n = 989, 49%). Although treatment times to percutaneous coronary intervention (PCI) were delayed approximately 21 minutes, in patients with acute myocardial infarctions occurring on weeknights and weekends, this modest delay did not adversely affect procedural success, myocardial recovery, or survival after PCI.