Influence of maternal labor time on delta-aminolevulinate dehydratase enzyme activity and markers of oxidative stress in newborns

Abstract

The purpose is to determine markers of oxidative stress related to the longer and shorter duration of labor (DOL) of pregnant women in the umbilical cord blood of neonates, not yet studied. Blood samples from the umbilical cord were collected from pregnant women with normal delivery and classified according to DOL in two groups: a group with DOL less than 310?min (n?=?33) and a group with DOL greater than or equal to 310?min (n?=?35). The oxidative stress parameters were analyzed by the quantification of thiobarbituric acid reactive substances (TBARS), nitrate/nitrite (NOx), protein thiol groups (P-SH) and non-protein (NP-SH), vitamin C and plasma iron reduction capacity (FRAP), in addition to the activity of the enzyme delta-aminolevulinate dehydratase (δ-ALA-D). The activity of the δ-ALA-D enzyme was shown to be decreased in longer DOL, however, the oxidant parameters and antioxidants were higher in the longer DOL, with the exception of NP-SH that was lower. The longer maternal DOL time is related to the alteration of δ-ALA-D enzyme activity and other parameters in neonates, suggesting an increase in the passage of maternal oxidative markers by umbilical cord blood.     

Conduire les premières consultations pour obésité en médecine générale. De l’analyse d’une demande à une proposition d’un suivi pour obésité: points forts et pièges à éviter

The quality of healthcare support about obese patients needs to customize rightly the basics of the healthcare plan. The challenges of the first consultations, for the general practitioner and his/her patient are even more important as they engage usually on a long term relationship. The therapeutic management of obese patients cannot be summed up as an energy imbalance between inputs and expenditures. The involved elements in this process are multiple and subtle. There are errors to avoid in order keeping off an impairment of the care relationship for a long time.     

An open trial of adjunctive escitalopram in bipolar depression

OBJECTIVE: This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic antidepressant, escitalopram, in the treatment of bipolar depression. METHOD: Twenty outpatients with DSM-IV bipolar depression types I and II were enrolled in a 12-week open trial of escitalopram, 10 mg daily, adjunctive to their ongoing mood stabilizer. Assessments were carried out using the Hamilton Rating Scale for Depression (HAM-D), the Young Mania Rating Scale (YMRS), and the Clinical Global Impressions for Severity (CGI-S) and Improvement (CGI-I) scales. The study was conducted from August 2003 to February 2004. RESULTS: Escitalopram was associated with significant improvement as measured by the HAM-D total score, which showed a mean reduction from baseline (mean = 20.9, SD = 4.2) to endpoint (mean = 8.9, SD = 3.6; p < .001) of 12 points. The mean CGI-S score decreased by 3.3 points (baseline: mean = 4.8, SD = 0.7; week 12: mean = 1.5, SD = 0.6; p < .001). Adverse events emerged in 75% of the patients (N = 15), usually of mild-to-moderate severity. Four dropouts took place due to manic switch (N = 1), hypomanic symptoms (N = 2), and hospitalization due to the emergence of suicidal ideation and psychosis (N = 1). CONCLUSION: These findings suggest that escitalopram in association with mood stabilizers may be an effective and reasonably well-tolerated treatment for patients with moderate-to-severe bipolar depression. The switch rate was similar to what is described in the literature for the selective serotonin reuptake inhibitors. Randomized controlled trials of escitalopram in bipolar depression are warranted.     

Changes in serological markers of hepatitis B virus after renal transplantation

An estimated 350 million persons worldwide are chronically infected with hepatitis B virus (HBV). Immunosuppression after renal transplantation seems to enhance viral replication and increase the risk of developing cirrhosis and hepatocellular carcinoma. This retrospective study was performed to assess the prevalence among and serological status of HBV infection after renal transplantation at a single university Brazilian center. Thirty six (4.2%) patients among 850 kidney recipients showed positive HBsAg for more than 6 months; 31 were hepatitis B surface antigen (HBsAg) positive at transplantation. Of the 15 hepatitis B e antigen (HbeAg) positive patients, six had spontaneous HBeAg seroconversion and three also had HBsAg clearance. An additional two showed HBeAg clearance with Lamivudine without seroconversion. Among 15 HBeAg-negative patients, three developed HBeAg reversion with no elevation of alanine transferase (ALT) levels and one had HBsAg clearance. Only one patient had acute exacerbation of hepatitis B (ALT > 20 times normal range) but remained HbeAg negative. During follow-up, five patients became HBsAg positive; two reactivations of resolved hepatitis B, two with previous anti-HBS induced by vaccination, and one with no serological marker for HBV. Lamivudine was prescribed for 16 patients, two of whom had HbeAg clearance without seroconversion and five who developed viral resistance to Lamivudine after a mean of 29.2 months. No hepatocellular carcinoma or deaths related to hepatitis B were seen in this group. In summary, prevalence of HBV in kidney transplant patients was 4.2%. Immunosuppression after renal transplantation in HBV infection led to an increased risk of liver complications and changes in HBV serological status.     

Das neue österreichische Patientenverfügungsrecht

Austria’s new Living Wills Act (Patientenverfügungsgesetz, or PatVG) that came into effect on 1st of June 2006, is the first law in Austria to regulate the controversial issue of living wills. The PatVG provides for a right to refuse future medical treatment by making an advance directive in the form of a living will that is either binding or “to be taken into consideration”. However, the establishment of a binding living will is governed by strict criteria as regards form and content, and both a medical doctor and a legal expert must be involved. Compliance with a living will is not allowed where there is a legal obligation to give medical treatment. There is also a legal obligation to give medical treatment in emergency situations where the time involved in looking for a living will could seriously endanger the health or the life of a patient.