Cytotoxicity of Technical Grade versus Formulations of Atrazine and Acetochlor Using Mammalian Cells

No abstract available.     

Accuracy of home pregnancy tests at the time of missed menses

OBJECTIVE: The purpose of this study was to investigate the validity of home pregnancy tests (HPTs) around the time of the missed menses. STUDY DESIGN: Levels of human chorionic gonadotropin (hCG) were determined in urine around the time of the missed menses, and 5th and 95th centiles were calculated. In a blind study evaluating 18 brands of HPTs, each was tested six times with five concentrations of hCG, 0 to 100 mIU/mL. Sensitivity was defined as the concentration at which six of six brands gave positive results, at the suggested reading time or at an extended time. RESULTS: It was estimated that a sensitivity of 12.5 mIU/mL was needed to detect 95% of pregnancies at the time of missing menses. Only 1 of 18 HPTs had this sensitivity. If faintly discernible results considered, 2 of 18 brands gave false-positive or invalid results. Clear positive results were given by only 44% of the brands at 100 mIU/mL hCG. If one accepted faintly discernible and extended reading times, all brands responded at 100 mIU/mL. A test with 100 mIU/mL sensitivity would detect approximately 16% of pregnancies at the time of missed menses. CONCLUSION: The utility of HPTs is questioned. Clinicians need to be aware of the limitations of current HPT brands.     

Effect of halogen light stimulation on nonstress testing

OBJECTIVE: This study was undertaken to determine whether external stimulation using a halogen light source influences fetal heart rate (FHR) responsiveness and nonstress test results. STUDY DESIGN: A total of 107 patients at 32 to 42 weeks' gestation undergoing a nonstress test were randomly assigned to have either transabdominal light stimulation or no light stimulation. The light (Vector Compact Sport Spot, Ft Lauderdale, Fla) was turned on for 10 seconds. If no qualifying FHR acceleration was observed, then the stimulus was repeated at 10-minute intervals for a maximum of 3 times. The investigators were blinded as to light stimulation for FHR interpretation. RESULTS: Reactive results were present in 52 cases in each group. Light stimulation led to a significantly shorter time (P <.02) until the first FHR acceleration (difference: 2.1 minutes; 95% CI 0.4-3.8 minutes). The height and width of the first acceleration were indistinguishable between groups. The time until a reactive result was significantly shorter after light stimulation (difference: 4.2 minutes; 95% CI 2.0-6.4 minutes). CONCLUSION: The earlier onset of FHR accelerations after halogen light stimulation prompted a more rapid reactive nonstress test result.     

Gestational trophoblastic neoplasia in American Indians

OBJECTIVE: To analyze gestational trophoblastic neoplasia (GTN) trends among American Indians (AI) using population-based data. STUDY DESIGN: GTN incidence, by race and age, was calculated using data collected by the New Mexico Tumor Registry over 29 years (1973-2001). Live birth, pregnancy and women at risk were tabulated using data derived from the state's vital record annual reports and from the registry. Statistical methods included trends analysis and Poisson regression. There is no national registry in the United States for all GTN. Therefore, the Surveillance, Epidemiology and End Results (SEER) database was used to identify choriocarcinoma cases in American Indians between 1973 and 1999. RESULTS: Within New Mexico, 1,082 cases of GTN were identified among 752,374 live births and 904,831 pregnancies, with ratios of 1:695 and 1:836, respectively, affecting 234 AI, 355 non-Hispanic whites (NHW), 463 Hispanic whites (HW) and 30 other nonwhites. Ratios per live births (pregnancy), respectively, were significantly higher in AI (AI 1:439 [1:487], NHW 1:739 [1:949], HW 1:783 [1:903]), as was age-adjusted incidence per 100,000 woman-years (AI 10.62, NHW 3.53, HW 5.15; all P<.0001). Using Poisson models with live birth and woman-year denominators, AI were found to be at increased risk for all GTN histologic subsets (complete, partial and invasive hydatidiform mole and choriocarcinoma). Of 524 total gestational choriocarcinoma cases identified within SEER, 8 (1.8%) affected American Indians; of them, 7 were from New Mexico. CONCLUSION: In New Mexico, AI continue to be at higher risk of GTN than are other groups. Given the rarity of choriocarcinoma within SEER, especially among AI, the New Mexico dataset provides the best available estimate of trends in U.S. AI GTN risk.     

Choosing abdominal incision and closure techniques: a review

This review summarizes contemporary concepts of abdominal surgical incision creation and closure. The Ovid computerized database was searched for articles published in English from 1996 to 2003 using keywords pertaining to the specific topic of interest (e.g., suture, drain, surgical technique, fascia). Human prospective, randomized trials; meta-analyses; and evidence-based-focused reviews were assessed and data abstracted. Several earlier and animal-based studies on specific issues were included. The data indicate that: (1) the direction of the incision should be based upon obtaining adequate exposure; (2) hair should either be left in place or clipped at the time of surgery; (3) a single dose of prophylactic antibiotics should be given 30 minutes prior to surgery; (4) using a "deep" scalpel is unnecessary; (5) a scalpel and electrocautery are comparable for deepening the incision; (6) minimal peritoneal lavage with non-antibiotic containing solutions is adequate; (7) the peritoneum should not be routinely closed; (8) the fascia should be loosely approximated by a continuous mass closure using a slowly absorbable, monofilament suture with the smallest possible caliber and a suture:wound length ratio of at least 4:1; (9) retention sutures, subcutaenous sutures and drains do not appear to reduce the risk of wound complications; and (10) the skin may be closed in a variety of methods, but a semiocclusive dressing should be applied. As scientific evidence accumulates to refute traditional dogma, management of the surgical patient has undergone substantial changes. Surgeons should now be able to create and close an abdominal wound based upon sound scientific principles rather than simply "doing what I always do."     

What medical students value most during their clinical clerkships from department chairs

OBJECTIVE: The purpose of this study was to evaluate the qualities that medical students value most in department chairs during clinical clerkships. STUDY DESIGN: All fourth-year students were asked to complete an anonymous survey voluntarily. The students ranked nine qualities of a chair using a visual analog scale that ranged from "strongly disagree" to "strongly agree." Also assessed was the student's level of contact with each department chair during the six core clerkships. RESULTS: Sixty-seven of 73 students (91.8%) completed the survey. Almost two thirds of the students (63%) had minimal or no contact with clinical chairs. The most desirable qualities of the department chair included advocating teaching by the residents and faculty, meeting with students (if possible, at the beginning, middle, and end of the clerkship), and participating in teaching in the classroom or clinic settings. Least important qualities involved knowing the student as a person and displaying an air of authority. The most common theme of written comments was that the department chair sets the tone for the department by advocating teaching and by encouraging respect for students. CONCLUSION: Medical students want clinical chairs to be visibly proactive toward teaching, meet with them periodically, and participate in teaching.     

Neurobehavior effects in four strains of mice offspring exposed prenatally to alprazolam

OBJECTIVE: This study was performed to determine whether prenatal exposure to alprazolam affects offspring behavior in different strains of mice. STUDY DESIGN: Eight to 11 gravid mice of the C3H/He, C57BL/6, A/J, and DBA/2 strains were given either an anxiolytic dose of alprazolam (0.32 mg/kg) or a placebo by gavage on day 18 of an anticipated 19- to 21-day gestation. Neurobehavior tasks were conducted to assess anxiety, learning and memory, and social interaction. Data were analyzed by analysis of variance or a Fisher exact probability test. RESULTS: Anxiety in alprazolam-exposed offspring was reduced in C3H/He (P <.05) and A/J (P <.05) newborn infants by separation vocalization but may be increased in the C3H/He adult strain on the plus maze task. Learning was slower among C57BL/6 mice exposed to alprazolam (P <.01), whereas memory was reduced in exposed A/J and DBA/2 offspring (P <.05). Alprazolam exposure was associated with more aggression among C3H/He and C57BL/6 male offspring (P <.01) and with less group activity by C57BL/6 offspring (P <.05). CONCLUSION: Altered behaviors in several mouse strains after prenatal exposure to alprazolam suggests a vulnerability of GABA-benozdiazepine receptor formation in fetal brain development.