Down syndrome biochemical markers and screening for preeclampsia at first and second trimester: correlation with the week of onset and the severity

OBJECTIVES: To estimate the combined screening performance of first and early second trimester prenatal serum markers for Down syndrome, in screening for the development of preeclampsia, and analyze the correlation among marker levels, week of onset, and severity of the disease. METHODS: A retrospective cohort study was carried out on 32 women with preeclampsia and 3044 controls. Serum samples from these pregnancies were assayed for pregnancy-associated plasma protein-A (PAPP-A), alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotrophin (hCG), and inhibin-A. A likelihood ratio and the odds of being affected given a positive result (OAPR) of various combinations of markers were calculated and receiver operating characteristic (ROC) curves analysis was performed. RESULTS: In the pregnancies that subsequently developed preeclampsia, first trimester PAPP-A concentration was significantly lower and concentrations of early second trimester inhibin-A and hCG significantly elevated. Levels of early second trimester uE3 and AFP were not significantly altered. We also found that inhibin-A correlates with both onset of the disease and the severity. CONCLUSION: Down syndrome biochemical markers levels are altered in those patients who subsequently developed preeclampsia and may be a useful screening test for preeclampsia. Inhibin-A is the most predictive marker and correlates with the severity of subsequent preeclampsia and inversely with the week of occurrence of preeclampsia.     

SAFE--the Special Non-invasive Advances in Fetal and Neonatal Evaluation Network: aims and achievements

In this short review, the objectives and work of SAFE--the Special Non-invasive Advances in Fetal and Neonatal Evaluation Network, a European Union Framework VI network of excellence is described. We demonstrate how this network facilitates the implementation of non-invasive prenatal diagnosis (NIPD) for single gene disorders, fetal rhesus typing, aneuploidy and pregnancy complications.     

RADIOACTIVE IRON AND ITS EXCRETION IN URINE,BILE, AND FECES

Radioactive iron as ferrous gluconate given by vein enables us to study iron excretion in urine, bile, and feces. There is an initial extra output in urine and feces during a few days (3 to 15 days) following the iron injection and this may total 2 to 8 per cent of the injected iron. Following this initial reaction the urinary excretion of radio-iron drops to traces or even to zero. The feces always contain measurable amounts of radio-iron—in five dogs receiving 100 to 250 mg. of radio-iron the fecal excretion per day settled down to 0.05 to 0.4 mg. per day. Blood destruction (acetyl-phenylhydrazine) causes a definite increase in radio-iron eliminated in the feces (0.1 to 1.0 mg. per day). Probably most of this excess iron comes through the biliary tract (bile fistula). The bile under usual conditions contributes very little iron to the intestine (0.01 mg. radio-iron per day or less). The body controls its iron stores by absorption or lack of it rather than by its capacity to eliminate it. The evidence is overwhelming that the dog excretes iron with difficulty and in small amounts (even in the plethoric state) by means of the biliary and gastro-intestinal tracts.     

RADIOACTIVE IRON AND ITS METABOLISM IN ANEMIA : ITS ABSORPTION,TRANSPORTATION, AND UTILIZATION

Artificially produced radioactive iron is an extremely sensitive agent for use in following iron in the course of its changes in body metabolism, lending itself to studies of absorption, transport, exchange, mobilization, and excretion. The need of the body for iron in some manner determines the absorption of this element. In the normal dog when there is no need for the element, it is absorbed in negligible amounts. In the anemic animal iron is quite promptly assimilated. The plasma is clearly the means of transport of iron from the gastrointestinal tract to its point of mobilization for fabrication into hemoglobin. The speed of absorption and transfer of iron to the red cell is spectacular. The importance of the liver and bone marrow in iron metabolism is confirmed.     

Einzelreferate und Buchbesprechungen

Ohne Zusammenfassung     

A comparison of the potencies and activities of progestogens used in contraceptives

The potencies and activities of six progestational agents, norethindrone, levonorgestrel, desogestrel, medroxyprogesterone acetate (MPA), progesterone (P) and norgestimate have been evaluated using standard laboratory bioassays. The endocrine activities measured are those most closely related to the clinically important actions of contraceptives. Relative potencies varied with parameter measured, route of administration and species showing clearly that each progestogen is a distinct pharmacological entity. The order of potency using oral administration for either ovulation inhibition or endometrial stimulation in rabbits was desogestrel greater than levonorgestrel greater than MPA greater than norgestimate greater than norethindrone. Levonorgestrel was more androgenic than desogestrel, and P, norethindrone, norgestimate and MPA were essentially devoid of androgen activity. This profile demonstrates clear differences in the potencies and activities of these progestogens and in their selectivity for target organs.     

Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians,Vegans and Omnivores in Germany

Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (V_max = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality.