Occupational predictors of pregnancy outcomes in Irish working women in the Lifeways cohort

Objective  The objective of this study was to explore the association between occupational factors and pregnancy outcomes in a prospective cohort of Irish pregnant women.
Design  This study has a prospective design.
Population  The Lifeways cohort included 1124 pregnant women, 676 of whom delivered a single baby and were working at their first prenatal care visit when they filled in a self-administered questionnaire.
Methods  Occupational factors were measured using this questionnaire and included eight factors describing job and working conditions. Data including pregnancy outcomes were also obtained from clinical hospital records. Logistic regression analysis was used to adjust for well-known risk factors.
Main outcome measures  Birthweight (≤3000 g and ≤2500 g), preterm delivery (<37 gestation weeks) and small-for-gestational-age.
Results  Significant associations were found between physical work demands and low birthweight (≤2500 g) and working with between a temporary contract and preterm delivery. Trends were also observed between working 40 hours or more a week and shift work, and birthweight of 3000 g or less. The study of a cumulative index showed that being exposed to at least two of these occupational factors significantly predicted birthweight of ≤3000 g (OR = 2.44, 95% CI: 1.17–5.08) and of ≤2500 g (OR = 4.65, 95% CI: 1.08–20.07) and preterm delivery (OR = 5.18, 95% CI: 1.00–27.01).
Conclusions  Our findings suggest that occupational factors may predict birthweight through their predictive effects on preterm delivery. This is one of the few prospective studies on pregnancy outcomes that include working conditions. As they may be modifiable, occupational factors deserve more attention in relation to birth outcomes.     

Variables affecting weight gain in renal transplant recipients

Previous studies of renal transplant recipients have suggested that weight gain after transplantation is relatively common, especially among certain populations. We conducted a retrospective review of 977 renal transplant recipients at the University of Alabama at Birmingham to identify patterns of weight change (as mean percentage of body weight at transplantation) attributed to race, sex, income, age at transplantation, pretransplantation time on dialysis, incidence of diabetes, rejection episode(s), and/or obesity (body mass index >/= 30 kg/m(2)) at transplantation. Patients were evaluated at 3, 6, 9, and 12 months posttransplantation and at 2 and 3 years, when available. Univariate analysis at 1 year showed that blacks achieved a greater weight change than whites (P = 0.0004), women had greater gains than men (P = 0.0001), and low-income patients had greater mean gains versus medium- (P = 0.0001) and high-income patients (P = 0.0001). Advancing age and weight gain were inversely correlated (P = 0.0002). Having one or more rejection episode indicated less weight gain than having no rejection episode (P = 0.0220). Incidence of diabetes or time on dialysis was not a significant predictor of weight gain. Black race, female sex, low income, younger age, and no incidence of rejection episodes were significantly associated with weight gain at 1 year in the multivariate analysis.     

Sonographic estimation of fetal weight in maerosomic fetuses: diabetic versus non-diabetic pregnancies

The objective of this study is to compare the accuracy of sonographic estimation of fetal weight of macrosomic babies in diabetic vs non-diabetic pregnancies. All babies weighing 4,000 g or more at birth, and who had ultrasound scans performed within one week of delivery were included in this retrospective study Pregnancies with diabetes mellitus were compared to those without diabetes mellitus. The mean simple error (actual birthweight--estimated fetal weight); mean standardised absolute error (absolute value of simple error (g)/actual birthweight (kg)); and the percentage of estimated birthweight falling within 15% of the actual birthweight between the two groups were compared. There were 9,516 deliveries during the study period. Of this total 1,211 (12.7%) babies weighed 4,000 g or more. A total of 56 non-diabetic pregnancies and 19 diabetic pregnancies were compared. The average sonographic estimation of fetal weight in diabetic pregnancies was 8% less than the actual birthweight, compared to 0.2% in the non-diabetic group (p < 0.01). The estimated fetal weight was within 15% of the birthweight in 74% of the diabetic pregnancies, compared to 93% of the non-diabetic pregnancies (p < 0.05). In the diabetic group, 26.3 % of the birthweights were underestimated by more than 15 %, compared to 5.4% in the non-diabetic group (p < 0.05). In conclusion, the prediction accuracy of fetal weight estimation using standard formulae in macrosomic fetuses is significantly worse in diabetic pregnancies compared to non-diabetic pregnancies. When sonographic fetal weight estimation is used to influence the mode of delivery for diabetic women, a more conservative cut-off needs to be considered.     

干细胞移植在帕金森病治疗中的应用与进展

目的:综述干细胞移植治疗帕金森病的机制与进展。资料来源:应用计算机检索Medline 2000-01/2006-12与干细胞移植治疗帕金森病相关的文章,检索词为“stem cell,Parkinson disease,transplantation”,限定文献语种为“English”;万方数据库2004/2007期间与有关文章,检索词为“干细胞,帕金森病,移植”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。选择所述内容与干细胞移植治疗帕金森病的机制及应用进展相关的文章,无论观察对象是实验动物还是患者全部纳入,重复的研究以近3年且发表在较权威杂志者优先。资料提炼:共收集到500余篇相关文献,52篇符合纳入标准,选用其中31篇作为本文参考文献。资料综合:干细胞能向特定神经细胞定向分化,并在动物模型身上取得明显的治疗效果,为干细胞移植治疗帕金森病带来了新的希望。另外,联合TH、胶质细胞源性神经营养因子基因治疗帕金森病,由于胶质细胞源性神经营养因子的神经营养作用和TH具有分泌多巴胺能神经递质的功能,既能提高脑内多巴胺水平,又能使多巴胺能神经元长期存活、阻止多巴胺能神经元变性,重建宿主神经通路。因此,把干细胞作为基因载体、进行干细胞移植联合多基因治疗,为帕金森病的治疗提供了新的思路。结论:目前大部分的干细胞治疗帕金森病的研究结论是基于动物实验的结果,它们能否在人类身上得到类似或更好的的结果,目前尚未可知,其分子机制、致瘤性及免疫排斥等问题还需进一步研究。     

Histone H1(o) expression in the developing cat retina.

Histone H1(o) is a subtype of the non-core H1 histones located in the linker region of DNA between nucleosome cores and postulated to be involved in the regulation of gene expression. Studies in both the mouse retina and rat brain have correlated the terminal differentiation of cell types in these tissues to the expression of H1(o)a The expression of H1(o) in mouse retina occurs after light exposure suggesting that light may trigger the expression of H1(o). The aims of the present research were to: (1) describe the relationship of the appearance of H1(o) protein immunoreactivity to the formation of cell types and layers in the cat retina; and (2) determine whether H1(o) may be dependent on exposure to light or on other postnatal developmental events. We find the nuclei of ganglion, amacrine, and prospective bipolar cells contain H1(o) immunoreactivity before birth, prior to the terminal differentiation of these cells. In the cat retina, expression of H1(o) occurs prior to light exposure. These results show that the expression of H1 degrees protein is not required for the terminal differentiation of retinal cell types in the cat. Additionally, we find no requirement for light exposure prior to H1(o) expression. These findings are at variance with the findings in the mouse retina and are inconsistent with any cross species requirement for the expression of this histone in the terminal differentiation of cell types in the retina.     

用气囊充气模拟结肠镜引起大鼠胃运动的变化

1 对象和方法成年雄性SD大鼠84只,清洁级,体质量(200±20) g. 置于安静、温暖(20℃)、避强光的环境中饲养. 随机均分成2组,每组42只; 再随机均分成7个亚组用于直肠顺应性检测,制定压力曲线.     

Cultural tailoring for the promotion of Hepatitis B screening in Turkish Dutch: a protocol for a randomized controlled trial

Background  

Chronic hepatitis B virus infection (HBV) is an important health problem in the Turkish community in the Netherlands, and promotion of screening for HBV in this risk group is necessary. An individually tailored intervention and a culturally tailored intervention have been developed to promote screening in first generation 16-40 year old Turkish immigrants. This paper describes the design of the randomized controlled trial, which will be used to evaluate the effectiveness of the two tailored internet interventions as compared to generic online information on HBV, and to assess the added value of tailoring on socio-cultural factors.     

Uterine rupture in the Netherlands: a nationwide population-based cohort study

Objective  To assess incidence of uterine rupture in scarred and unscarred uteri and its maternal and fetal complications in a nationwide design.
Design  Population-based cohort study.
Setting  All 98 maternity units in the Netherlands.
Population  All women delivering in the Netherlands between August 2004 and August 2006 ( n  = 371 021).
Methods  Women with uterine rupture were prospectively collected using a web-based notification system. Data from all pregnant women in the Netherlands during the study period were obtained from Dutch population-based registers. Results were stratified by uterine scar.
Main outcome measures  Population-based incidences, severe maternal and neonatal morbidity and mortality, relative and absolute risk estimates.
Results  There were 210 cases of uterine rupture (5.9 per 10 000 pregnancies). Of these women, 183 (87.1%) had a uterine scar, incidences being 5.1 and 0.8 per 10 000 in women with and without uterine scar. No maternal deaths and 18 cases of perinatal death (8.7%) occurred. The overall absolute risk of uterine rupture was 1 in 1709. In univariate analysis, women with a prior caesarean, epidural anaesthesia, induction of labour (irrespective of agents used), pre- or post-term pregnancy, overweight, non-Western ethnic background and advanced age had an elevated risk of uterine rupture. The overall relative risk of induction of labour was 3.6 (95% confidence interval 2.7–4.8).
Conclusion  The population-based incidence of uterine rupture in the Netherlands is comparable with other Western countries. Although much attention is paid to scar rupture associated with uterotonic agents, 13% of ruptures occurred in unscarred uteri and 72% occurred during spontaneous labour.