The relationship of drinking and birth outcome in a US national sample of expectant mothers

Alcohol consumption by pregnant women and birth outcome were studied in 9953 livebirths, 3309 fetal deaths and 5332 infant deaths from the 1988 National Maternal and Infant Health Survey. In crude analyses, race, age, mother's education, prenatal care, parity, low birthweight, gestational age, smoking and alcohol consumption during pregnancy were significantly related to the occurrence of fetal deaths and infant deaths. Among women having livebirths, race, age, mother's education, prenatal care, prematurity, gestational age, smoking and alcohol consumption during pregnancy were significantly related to having a low birthweight baby (< 2500 g). In this group, women who drank more during pregnancy also smoked more, were younger and less educated than women who drank at lower levels or not at all. The relationship of alcohol consumption during pregnancy and infant birthweight for those women having livebirths was studied using multivariable linear regression. The results indicated that race, mother's education, baby's sex, parity, mother's height, mother's body mass index and smoking, but not alcohol consumption, were significantly related to birthweight. Multivariable logistic regressions were performed for the occurrence of low birthweight, fetal death and infant death. The effect of alcohol was significant in all these analyses. These results indicate that alcohol has an important relationship with birth outcome, but that for the drinking reported in this study, the alcohol effect on mean birthweight is small relative to that of other risk factors, accounting for the non-significant result in the multiple linear regression.     

Identification of an extensive ζ-α globin gene deletion in a Chinese individual

We describe a novel alpha-thalassaemia-1 deletion that removes the entire zeta-alpha globin gene cluster. A Chinese couple were referred for counselling after two consecutive pregnancies ended with fetal hydrops. Gene mapping was used to demonstrate that the mother is heterozygous for the South-east Asia alpha-thalassaemia-1 deletion (zeta zeta zeta alpha alpha/zeta zeta--SEA), while the father carries an alpha-thalassaemia-1 deletion of more than 100 kilobases (zeta zeta alpha alpha/----). This newly discovered deletion extends for unknown distances 3' and 5' of the zeta-alpha globin gene cluster and has been designated (--HW).     

The Decline in Serum Albumin after Conversion to High Flux, High Efficiency Dialysis

Abstract: Hypoalbuminemia among chronic hemodialysis patients is recognized as a poor prognostic sign. We observed that many of our chronic patients had a progressive decrease in their plasma albumin concentrations after they were converted to high flux, high efficiency dialysis from conventional dialysis mode. This change occurred in the absence of changes in the KTIV and protein catabolic rate (per) normalized to body mass. When nitrogen losses were measured, we found no difference in the dialysate concentrations of urea, alpha amino nitrogen, uric acid, or total nitrogen when high flux polysulfone was compared with high efficiency Cuprophan. While urea was the predominant nitrogen solute in all dialysate samples, there were some with a large gap between total and urea nitrogen. Alpha amino nitrogen losses, expressed as leucine equivalents, were substantial, ranging from 8. 4 to 9. 8 g/3. 5 h dialysis treatment. We believe that the increased losses of nitrogen experienced by patients after their conversion to a more efficient method of dialysis and not compensated for by a spontaneous increased intake of protein led to the observed fall in plasma albumin. Both urea and amino acid nitrogen losses need to be accounted for when achievement of higher KTIV dialysis is pursued.     

The change process in alcoholics: client motivation and denial in the treatment of alcoholism within the context of contemporary nursing

Despite being constantly cited as a critical intervening variable in the recovery from alcohol problems, there is a paucity of literature on client motivation. This paper reviews the current literature which impacts on motivation and its importance in treatment and develops in a stepwise manner the revised expectancy/motivation hypothesis, tentatively explaining both motivation and denial as a natural process in behavioural change. Because of the revised expectancy/motivation hypothesis' distinctly defined stages which closely relate to the process of nursing and the qualitative and quantitative measurement it entails which the nursing process demands, it offers a particularly appropriate model for treatment within nurse practice.     

Using a dense PTFE membrane without primary closure to achieve bone and tissue regeneration.

The most common types of barrier membranes used for bone or tissue regeneration are made of expanded-polytetrafluoroethylene (e-PTFE) or resorbable materials, such as collagen. Both the e-PTFE and resorbable membranes require primary soft tissue coverage. This article explores the use of a dense-polytetrafluoroethylene (d-PTFE) membrane, which does not require primary soft tissue coverage. The advantages of d-PTFE in contrast to the other more commonly used types of barrier membranes and the clinical significance of these advantages for implant surgical and restorative treatment are discussed.     

Injuries to the liver. Study of 54 cases

The records of 54 consecutively treated patients with hepatic trauma were reviewed. Diagnosis, treatment and results were analyzed. Clinical features and ultra sonography were deciding for diagnosis. Frequent associated injuries are due to mechanism of injury 74% of road accident. 50% of lesions were major. Treatment were hemostasis, by suture and packing. Only 6 major hepatectomy were realised. Total mortality is 15% due to incomplete initial treatment or to extra-hepatic injury. Morbidity is important due to sepsis and hemorrhage. Therapeutic evolution showed decline of resection for conserving operation.     

Antennular projections to the midbrain of the spiny lobster. I. Sensory innervation of the lateral and medial antennular neuropils

The organization of sensory afferents in the antennular nerve (AN) of the spiny lobster and the central arborization of the afferents in the lateral and medial antennular neuropils (LAN, MAN) were analyzed by backfilling the AN with biocytin. The MAN receives primarily thick afferents (diameter ≥ 10 μm) with a consistent pattern of arborization from the medial of the three major divisions of the AN. The LAN, in contrast, receives many thin to medium-sized afferents (diameter ≤ 0.3–5 μm), in addition some with diameters ≥ 5 μm, from the lateral and dorsal divisions of the AN. In contrast to the consistent pattern of arborization in the MAN, afferents projecting to the LAN arborize in widely different patterns. Serially arranged, orthogonal side branches that are suggestive of topographical representation of the serially arranged sensilla on the antennule contribute to the stratification of the LAN. Together with existing electrophysiological data, these morphological findings are consistent with the idea that the MAN receives primarily mechanosensory (largely statocyst) input, as previously thought, but that the LAN receives chemosensory as well as mechanosensory input. The chemosensory input to the LAN would represent a novel pathway for processing chemosensory input from the antennule.