Asthma medication use in pregnancy and fetal growth

BACKGROUND: Given the high prevalence of asthma in pregnancy, it is important to understand the relationship between asthma medications and fetal growth in the context of appropriate treatment. OBJECTIVE: This study examines the effect of inhaled corticosteroids, systemic corticosteroids, and beta(2)-agonists on fetal growth in 654 infants born to women with asthma compared with 303 infants born to controls without asthma. METHODS: Subjects for this prospective study were enrolled throughout North America between 1998 and 2003 and followed up by the Organization of Teratology Information Services. Incidence of small for gestational age (SGA) infants and mean birth size measures were compared among groups. RESULTS: Mean birth weight of full-term infants born to mothers who used systemic corticosteroids (3373 g) was lower than in the beta(2)-agonist group (3552 g) and controls without asthma (3540 g; P < .05) after adjustment for other risk factors. However, no differences in the incidence of SGA for weight were observed among groups. Adjusted mean birth length was slightly shorter in the systemic steroid group compared with controls (P=.02). Incidence of SGA for length and head circumference and mean head circumference did not vary among groups (P>.05). CONCLUSION: The treatment of asthma with systemic corticosteroids resulted in a deficit of about 200 g in birth weight compared with controls and exclusive beta(2)-agonist users and no increased incidence of SGA. These results suggest that asthma management with beta(2)-agonists and/or inhaled corticosteroids during pregnancy does not impair fetal growth, whereas systemic corticosteroids have a minimal effect which should be weighed against the necessity to control severe asthma.     

Caspase inhibitors induce a switch from apoptotic to proinflammatory signaling in CD95-stimulated T lymphocytes

CD95 is a major apoptosis receptor that induces caspase activation and programmed cell death in susceptible cells. CD95-induced apoptosis can be blocked by peptidic caspase inhibitors such as benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone or Ile-Glu-Thr-Asp-fluoromethyl ketone. Here we show that stimulation of CD95 in the presence of these inhibitors induces necrosis and expression of various proinflammatory cytokines in primary T lymphocytes, such as TNF-alpha, IFN-gamma and granulocyte/macrophage colony-stimulating factor. In the absence of caspase inhibition CD95 stimulation did not result in cytokine expression, indicating that this proinflammatory signaling pathway is suppressed by active caspases. Further analysis with A3.01 T cells revealed that the proinflammatory signaling activity of CD95 was mediated by MEK/ERK, p38 and NF-kappaB signaling pathways. These findings point to a pivotal role of caspases not only as mediators of apoptosis but also as enzymes that prevent proinflammatory signaling during CD95-induced apoptosis. Moreover, our findings may be useful for the development of novel pharmacological strategies.     

The effect of aging on IgD receptor expression by T cells and its functional implications

Summary: Exposure to oligomeric or aggregated (a), but not to mono-merle (m), IgD causes a rapid (within 1 h) upregulation of IgD-R expression on CD4⁺ T cells from young, but not from aged, mice and on both CD4⁺ and CD8⁺ T cells from all young and from =65% of aged humans. In normal young (but not in IgD^−/-) mice, this increase in IgD-R expression is associated with a marked increase in primary and secondary antibody responses, transferable to both aged and young mice with T cells from aIgD pretreated donors. In both species, immunization causes a rise in the IgDR⁺ expression in vivo in the young. In mice, mIgD abolishes both the Induction of IgD-R expression and augmentation of immune responses, suggesting that interaction between IgD-R⁺ T and IgD⁺ B cells is needed. In aged humans, the ability of peripheral blood lymphocytes to exhibit IgD-R expression in response to aIgD in vitro or to influenza vaccine in vivo is strongly correlated to the individual's ability to produce antibody. In T cells from aged mice, but not from aged IgD-non-responder humans, IgD-R are able to come to the cell surface if an additional signal has been supplied, such as by (ionomycin/thapsigargin + aIgD). Agents which induce IgD-R and augmentation of antibody production in aged and young mice include phosphatidylcholine and dehydroepiandrosterone sulfate. The immunoaugmenting effect of pretreatment with these agents appears Indeed due to IgD-R⁺ T cells, because it is abolished by mIgD.     

An adjective list for assessing emotional expressivity in psychotherapy research

Background: Several forms of psychotherapy aim at improving their patients' emotional expressivity, which is considered to contribute to mental health. Studies on the success of such attempts are virtually absent. Aim: To develop a measure for assessing changes of emotional expressivity in the course of psychotherapy. Method: In study 1 (N = 321), we generated a pool of German adjectives referring to emotional expressivity and reduced the number of those adjectives by means of factor‐analysis. In study 2 (N = 103), we determined how emotional expressivity is related to the Big Five personality factors. Results: An expressivity scale of 12 items with highly satisfactory psychometric properties was construed. Emotional expressivity is substantially related to Extraversion and moderately related to Agreeableness and Openness. Conclusion: The scale is ideally suited for repeated assessments in the course of psychotherapy in multi‐agent (e.g., inpatient) settings. Copyright © 2007 John Wiley & Sons, Ltd.     

Mice with mutations in Mahogunin ring finger-1 (Mgrn1) exhibit abnormal patterning of the left-right axis.

Mahogunin Ring Finger 1 (Mgrn1) encodes a RING-containing protein with ubiquitin ligase activity that has been implicated in pigment-type switching. In addition to having dark fur, mice lacking MGRN1 develop adult-onset spongy degeneration of the central nervous system and have reduced embryonic viability. Observation of complete situs inversus in a small proportion of adult Mgrn1 mutant mice suggested that embryonic lethality resulted from congenital heart defects due to defective establishment and/or maintenance of the left-right (LR) axis. Here we report that Mgrn1 is expressed in a pattern consistent with a role in LR patterning during early development and that many Mgrn1 mutant embryos show abnormal expression of asymmetrically expressed genes involved in LR patterning. A range of complex heart defects was observed in 20-25% of mid-to-late gestation Mgrn1 mutant embryos and another 20% were dead. This finding was consistent with 46-60% mortality of mutants by weaning age. Our results indicate that Mgrn1 acts early in the LR signaling cascade and is likely to provide new insight into this developmental process as Nodal expression was uncoupled from expression of other Nodal-responsive genes in Mgrn1 mutant embryos. Our work identifies a novel role for MGRN1 in embryonic patterning and suggests that the ubiquitination of MGRN1 target genes is essential for the proper establishment and/or maintenance of the LR axis.     

Frequent transmission of enterococcal strains between mechanically ventilated patients treated at an intensive care unit

The objectives of this investigation were to study the respiratory tract colonization and transmission of enterococci between 20 patients treated with mechanical ventilation at an intensive care unit (ICU), to compare genotyping with phenotyping, and to determine the antibiotic susceptibilities of the isolated enterococci. Samples were collected from the oropharynx, stomach, subglottic space, and trachea within 24 h of intubation, every third day until day 18, and thereafter every fifth day until day 33. Enterococcal isolates (n = 170) were analyzed by pulsed-field gel electrophoresis and with the PhenePlate (PhP) system. The antimicrobial susceptibilities to five agents were determined. Seventeen of the 20 subjects were colonized with enterococci in the respiratory tract; 12 were colonized in the lower respiratory tract. Genotype analyses suggested that 13 patients were involved in a transmission event, including all patients intubated more than 12 days. In conclusion, colonization of resistant enterococci in the respiratory tract of intubated patients treated at an ICU was common. Transmission of enterococci between patients occurred frequently. Prolonged intubation period seems to be a risk factor for enterococcal cross-transmission.     

Chlorimipramine,electroconvulsive shock and combination thereof: Differential effects of chronic treatment on apomorphine-induced behaviours and on striatal and mesocortical dopamine turnover

Summary We studied the influence of different pretreatment regimens (Chlorimipramine-Cmi, electroconvulsive shock-ECS, and Cmi+ECS all regimens being applied for either 2 or 15 days) on the open field behaviour, on the striatal and on the prefrontal dopamine-PFC DA turnover in rats injected with either apomorphine-AP 25 g/kg (stimulating presynaptic DA receptors), AP 200 g/kg (stimulating postsynaptic DA receptors), or vehicle (control).In the controls, AP 25 g/kg reduced the locomotor activity and the striatal, but not the PFC DA turnover. AP 200 g/kg increased the locomotor activity and reduced the striatal but not the PFC DA turnover.Short-term pretreatment: ECS and Cmi+ECS prevented the decrease of striatal DA turnover after AP 25 g/kg. No other influence of any pretreatment on behaviour or DA-turnover became significant.Long-term pretreatment: Chronic Cmi: marginally increased the open field behaviour and marginally decreased the PFC DA turnover; significantly increased the effect of AP (200 g/kg) on striatal DA turnover and the effect of AP (25 and 200 g/kg) on PFC DA turnover. Repeated ECS: decreased locomotion and rearing and increased PFC DA turnover; increased the effect of AP (200 g/kg) on locomotion and on striatal DA turnover; decreased the effect of AP (25 and 200 g/kg) on PFC DA turnover.Chronic Cmi+ECS: decreased locomotion and rearing and marginally decreased PFC DA turnover; increased the effect of AP on hyperlocomotion and on striatal DA turnover. No other influence of any chronic pretreatment on behaviour or on DA turnover became significant.The data support the view that chronic AD therapies increase DAergic functions related to postsynaptic rather than to presynaptic structures. It is suggested that the different effects of chronic Cmi and repeated ECS on AP-evoked PFC DA turnover help to understand the different influences exerted by both treatments on rats' behaviour.     

“Making Room”: A Thematic Analysis Study of the Process of Postpartum Maternal Adjustment

Maternal and Child Health Journal - Mothers are especially vulnerable to the onset or recurrence of psychological symptoms during the postpartum period. However, protective psychosocial factors may...