The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo,Brazil

Background  

Both violence and depression during pregnancy have been linked to adverse neonatal outcomes, particularly low birth weight. The aim of this study was to investigate the independent and interactive effects of these maternal exposures upon neonatal outcomes among pregnant adolescents in a disadvantaged population from Sao Paulo, Brazil.     

High-resolution array CGH clarifies events occurring on 8p in carcinogenesis

Background  

Rearrangement of the short arm of chromosome 8 (8p) is very common in epithelial cancers such as breast cancer. Usually there is an unbalanced translocation breakpoint in 8p12 (29.7 Mb – 38.5 Mb) with loss of distal 8p, sometimes with proximal amplification of 8p11-12. Rearrangements in 8p11-12 have been investigated using high-resolution array CGH, but the first 30 Mb of 8p are less well characterised, although this region contains several proposed tumour suppressor genes.     

Effects of sleep deprivation on neural circulatory control

Effects of sleep deprivation on neural cardiovascular control may have important clinical implications. We tested the hypothesis that sleep deprivation increases heart rate, blood pressure, and sympathetic activity and potentiates their responses to stressful stimuli. We studied 8 healthy subjects (aged 40+/-5 years, 6 men and 2 women). Blood pressure, heart rate, forearm vascular resistance, and muscle sympathetic nerve activity were measured at rest and during 4 stressors (sustained handgrip, maximal forearm ischemia, mental stress, and cold pressor test). Measurements were obtained twice, once after normal sleep and once after a night of sleep deprivation. All measurements were obtained in a blinded, randomized manner. In comparison with normal sleep, sleep deprivation resulted in an increase in blood pressure (normal sleep versus sleep deprivation=82+/-8 versus 86+/-7 mm Hg, mean+/-SEM, P=0.012) and a decrease in muscle sympathetic nerve activity (normal sleep versus sleep deprivation=28+/-6 versus 22+/-6 bursts/min, P=0.017). Heart rate, forearm vascular resistance, and plasma catecholamines were not significantly changed by sleep deprivation, nor did sleep deprivation affect autonomic and hemodynamic responses to stressful stimuli. Sleep deprivation results in increased resting blood pressure, decreased muscle sympathetic nerve activity, and no change in heart rate. Thus, the pressor response to sleep deprivation is not mediated by muscle sympathetic vasoconstriction or tachycardia.     

Two-stage repair of extensive subglottic tracheal stenosis

Summary The authors describe an open technique that has been used over the past 25 years to reconstruct the subglottic tracheal region in two stages after extensive laryngotracheal stenosis. After submucosal resection of fibrous tissue and reconstruction of the subglottic and tracheal skeleton by means of two autologous osseous grafts, a large laryngotracheostomy is created during the initial stage. Some weeks later, in the second stage, the anterior wall is closed, using two cervical hinge-door flaps. Ten patients have undergone this procedure, with a minimum follow-up of 3 years. All of the patients were decannulated upon completion of the treatment without recurrence of stenosis during the follow-up period.     

Must Macrosomic Fetuses be Delivered by a Caesarean Section? A Review of Outcome for 786 Babies ≥ 4,500 g

Because difficult vaginal delivery is more frequent with macrosomic fetuses, some writers recommend routine Caesarean section for the delivery of fetuses greater than or equal to 4,500 g. The purpose of this study was to evaluate the appropriateness of this recommendation. A retrospective review was undertaken to determine how many fetuses born in our hospital weighing greater than or equal to 4,500 g died or were permanently damaged as a consequence of mechanical difficulties at delivery. During a 10-year period, 590 (75%) of 786 cephalic babies weighing greater than or equal to 4,500 g and alive at the start of labour were born vaginally. No baby died or was permanently damaged as a consequence of mechanical difficulties at delivery. Routine Caesarean section for macrosomic fetuses to prevent death or damage from difficult delivery is not warranted by our results.     

Genetic alterations in head and neck cancer.

Mutations of the ras gene family appear to be an uncommon genetic alteration in SCCHN. A common region of DNA amplification on chromosome 11q13 has been identified in SCCHN. A cluster of proto-oncogenes (int-2, hst-1, bcl-1, prad-1) has been localized to the 11q13 region. Studies are needed to determine the critical genes in 11q13 whose expression drive the amplicon. Mutations of the p53 tumor suppressor gene are the most common genetic alteration in SCCHN. The hope is that dysregulated oncogenes or tumor suppressor genes may be targets for specific therapy.