Prevalence of behaviour disorders in low birthweight infants

OBJECTIVE--To determine the prevalence of behaviour disorders in low birthweight infants. DESIGN--Children of birth weight < or = 2000 g born to mothers resident in Merseyside in 1980-1 assessed using the Rutter parent and teacher behaviour questionnaires and the Conner modification of the Rutter teacher questionnaire. Children attending normal schools were assessed with controls matched for age, sex, and class in school. Children attending special schools were assessed unmatched. SUBJECTS--233 matched case-control pairs attending normal primary schools and 46 unmatched children attending special schools. SETTING--Primary and special schools. MAIN OUTCOME MEASURES--Emotional, conduct, and undifferentiated behaviour disorders and hyperactivity. RESULTS--On the parental questionnaire screen, 36% of the cases and 22% of the controls had a behaviour disorder and on the teacher questionnaire the proportions were 27% and 12% respectively. Hyperactivity was significantly more common among male cases than their controls (21% v 5.0%) but differed little among female cases and controls (9% v 7%). CONCLUSIONS--Improving neonatal survival of low birthweight infants is accompanied by a higher prevalence of behaviour disorders. The long term implications for psychiatric morbidity and other adult disease must be monitored.     

BENIGN GASTROCOLIC FISTULA ASSOCIATED WITH PERITONITIS

SUMMARY Gastrocolic fistula is most often related to malignancy or previous gastric surgery. It is an uncommon complication of benign gastric ulceration in patients who have not had a previous operation. Benign gastrocolic fistula associated with peritonitis is extremely rare — this case is only the fourth ever reported. The patient presented with an acute abdomen, and subsequent investigations demonstrated a gastrocolic fistula of benign aetiology.     

The underregistration of neonatal deaths: Georgia 1974--77.

We reviewed the neonatal outcome of 3,369 infants who weighed less than or equal to 1500 grams and who were born in Georgia during the years 1974--76. We matched 1,465 of these infants with a death certificate registered in the State's Vital Records. Upon review of the hospital records of the remaining infants, we identified 453 infants that died during the neonatal period without a death certificate being registered. Subsequently, we compared the hospital death registries for 1977 in Georgia and death certificates registered in Vital Records during 1977. We identified an additional 236 infants who died without a death certificate being registered. Forty per cent of these infants weighed greater than 1500 grams. Two major procedural errors regarding the filing of death certificates in Georgia at the local level contributed to this 21 per cent underregistratioon of neonatal deaths in 1974--77. The underregistration occurred disproportionately for rural areas, for unmarried mothers, and for Black infants. The reason for underregistration included failure of hospitals and morticians to file death certificates with the county registrars.     

Changes in Na channel properties of frog and rat skeletal muscles induced by the AaH II toxin from the scorpion Androctonus australis

The effects of the mammal toxin II isolated from the venom of the scorpion Androctonus australis Hector (AaH II) were studied under current and voltage clamp conditions in frog (semitendinosus) and rat (fast e.d.l. and slow soleus) skeletal twitch muscle fibres. In both species, AaH II induced a dose-dependent prolongation of the action potential (AP) leading at saturating concentration to APs with long plateaus of about 1.5 s in frog and 5 s in rat e.d.l. and soleus fibres. The concentrations to induce 50% of the maximal effect (K _0.5) were 9.1×10^–9 M in the frog and 1.4×10^–9 M in the rat. AaH II increased the time constants of inactivation of the peak Na current and induced a maintained Na current that was greater in rat e.d.l. and soleus (31.6 % of peak current amplitude at — 30 mV; K _0.5= 0.8×10^–9M) than in frog (16.5%; K _0.5=15.5 ×10^–9 M) muscles. Peak and maintained Na currents were TTX-sensitive and had identical threshold and reversal potentials. The half-maximum maintained permeability occurred at a potential 20 mV more positive than the peak permeability. Recovery from inactivation and steady-state inactivation of the inactivating Na current remained unchanged. The maintained current deactivated with normal fast kinetics. The action of the toxin reversed poorly on washout but could be largely removed by conditioning depolarizations more positive than the reversal potential of the Na current. Our results suggest that, in vertebrate skeletal muscle fibres, AaH II affects all the Na channels and are consistent with the hypothesis that the maintained current originates from a reopening of previously inactivated Na channels.     

Perinatal and maternal mortality in a religious group avoiding obstetric care

We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a perinatal mortality rate three times higher and a maternal mortality rate about 100 times higher than the statewide rates. These findings suggest that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death.     

Enhanced pregnancy-associated mortality surveillance: Minnesota, 1990-1999

Comprehensive surveillance is critical to accurate identification of pregnancy-associated deaths and risk factors and is the first step in implementing programs to prevent such deaths in young women. In Minnesota, surveillance is currently based on analysis of data from death records. This study sought to demonstrate that the state's current surveillance method underestimates the actual burden of maternal deaths in Minnesota. It proposes that ongoing enhanced surveillance--analysis of death certificate data combined with the linking of death records of women of reproductive age with live birth records or fetal death records--provides a more complete and accurate accounting of pregnancy-associated mortality in Minnesota.     

The novel monoamine reuptake inhibitor and potential antidepressant, S33005, induces Arc gene expression in cerebral cortex

Recent data show that corticolimbic expression of the effector immediate early gene Arc is up-regulated by standard antidepressant drugs. Here, we tested the effect upon Arc expression of a novel antidepressant and selective 5-hydroxytryptamine/noradrenaline reuptake inhibitor (SNRI), (-)1-(1-dimethylaminomethyl) 5-methoxybenzocyclobutan-1-yl) cyclohexanol (S33005). Arc mRNA abundance in frontal, cingulate, orbital and parietal cortices, hippocampus (CA1 pyramidal layer) and striatum was elevated in rats treated daily for 14 but not 7 days with 10 mg/kg i.p. S33005 compared to saline. Fourteen but not 7 days treatment with 10 mg/kg i.p. venlafaxine, the prototypical SNRI, also elevated Arc mRNA, but its effects were not as pronounced and detected in fewer regions, compared to S33005. Neither S33005 nor venlafaxine altered Arc mRNA after acute injection nor altered brain derived neurotrophic factor mRNA after repeated administration. These data demonstrate that sustained treatment with SNRIs increases Arc expression in corticolimbic regions, and underpin previous neurochemical and behavioural evidence that S33005 is efficacious in models predictive of antidepressant action.