Total versus subtotal hysterectomy: a survey of current views and practice among British gynaecologists.

This paper reports the results of a postal questionnaire, with a response rate of 61 per cent. It is clear from the results that subtotal hysterectomy is an unpopular operation in the United Kingdom. Although a majority of consultants felt that subtotal hysterectomy was less likely to affect urinary, bowel and sexual function, this did not seem to affect decision making. Seventy-eight per cent of female gynaecologists would prefer a total hysterectomy for themselves rather than a subtotal procedure.     

Food advertising and broadcasting legislation—a case of system failure?

This study analysed a sample of food advertisements shown during 63 hours of children's programming to investigate compliance and non‐compliance with one of the Australian Children's Television Standards (CTS): CTS 20.2a. This standard regulates the way premium offers may, and may not, be used to sell products to children. Of the 1721 advertisements contained in the sample, 544 (32%) were for food. A significantly higher number of food advertisements (41%) were shown during ‘C’ programs (which are specifically regulated and produced for children six to 13 years of age and suitable for viewing without adult supervision), compared with 30% during the less regulated ‘G’ programs (P= < 0.001) (suitable for children to view without adult supervision but not produced specifically for a child audience). Over one‐third of food advertisements (36%) in ‘C’ time contained a premium offer compared with 17% in ‘G’ time (P= < 0.0001). Using a precisely defined interpretation of CTS 20.2a, this study found 30 (31%) of food advertisements breached the standard during ‘C’ programs. This was a significantly higher proportion than the 54 (12%) of breaches in ‘G’ time (P= < 0.0001). From this study, the current regulatory system has not resulted in more responsible food advertising during ‘C’ programs, and the widespread breaches of CTS 20.2a indicate this standard is ineffective as a means of regulating food advertising. The Australian Broadcasting Authority has recognised that children need protection from unfair marketing practices and the improper use of premium offers to promote a food product, therefore CTS 20.2a needs urgent review to make it more effective.     

Socioeconomic variables and rates of diarrhoeal disease in urban Bangladesh

Sociodemographic factors including low maternal education, low economic status, inferior quality of housing, diminished access to water and sanitation facilities, and crowding in the household are associated with increased diarrhoea in the rural setting of many developing countries. To assess the relationship of these variables with diarrhoea rates in children in an urban setting we monitored the episodes of diarrhoea of children less than 6 years of age from 1921 families living in 51 clusters throughout Dhaka city, Bangladesh, for 3 1/2 months. Comparing incidence density ratios, we found that, of the factors listed above, only low family income and living in a one-room house were statistically associated with increased diarrhoea and that none of these variables was associated with a meaningfully increased risk of diarrhoea. We conclude that the risk factors for increased episodes of diarrhoea in the urban setting appear to be different from those of the rural setting.     

Soiled saris: a vector of disease transmission?

We examined the relationship between uses of the sari that are potential health hazards and episodes of diarrhoea in children younger than 6 years in 247 families living in 51 slums in Dhaka, Bangladesh. These misuses appeared to be common (median of three per observation period) and were largely unrecognized by the women as possible sources of disease transmission. There appeared to be a positive correlation between the number of misuses of the sari and episodes of childhood diarrhoea.     

Evidence of a role for cyclic ADP-ribose in long-term synaptic depression in hippocampus

Ca2+ released from presynaptic and postsynaptic intracellular stores plays important roles in activity-dependent synaptic plasticity, including long-term depression (LTD) of synaptic strength. At Schaffer collateral-CA1 synapses in the hippocampus, presynaptic ryanodine receptor-gated stores appear to mobilize some of the Ca2+ necessary to induce LTD. Cyclic ADP-ribose (cADPR) has recently been proposed as an endogenous activator of ryanodine receptors in sea urchin eggs and several mammalian cell types. Here, we provide evidence that cADPR-mediated signaling pathways play a key role in inducing LTD. We show that biochemical production of cGMP increases cADPR concentration in hippocampal slices in vitro, and that blockade of cGMP-dependent protein kinase, cADPR receptors, or ryanodine-sensitive Ca2+ stores each prevent the induction of LTD at Schaffer collateral-CA1 synapses. A lack of effect of postsynaptic infusion of either cADPR antagonist indicates a probable presynaptic site of action.     

Cardiovascular health and economic effects of smoke-free workplaces

PURPOSE: Smoking is the leading controllable risk factor for heart disease. Only about 69% of U.S. indoor workers are currently covered by a smoke-free workplace policy. This analysis projects the cardiovascular health and economic effects of making all U.S. workplaces smoke free after 1 year and at steady state. METHODS: We estimated the number of U.S. indoor workers not covered by smoke-free workplace policies, and the effects of making all workplaces smoke free on smoking behavior and on the relative risks of acute myocardial infarctions and strokes. One-year and steady-state results were calculated using an exponential decline model. A Monte Carlo simulation was performed for a sensitivity analysis. RESULTS: The first-year effect of making all workplaces smoke free would produce about 1.3 million new quitters and prevent over 950 million cigarette packs from being smoked annually, worth about 2.3 billion dollars in pretax sales to the tobacco industry. In 1 year, making all workplaces smoke free would prevent about 1500 myocardial infarctions and 350 strokes, and result in nearly $60 [corrected] in savings in direct medical costs. At steady state, 6250 myocardial infarctions and 1270 strokes would be prevented, and $279 million [corrected] would be saved in direct medical costs annually. Reductions in passive smoking would account for 60% of effects among acute myocardial infarctions. CONCLUSION: Making all U.S. workplaces smoke free would result in considerable health and economic benefits within 1 year. Reductions in passive smoking would account for a majority of these savings. Similar effects would occur with enactment of state or local smoke-free policies.     

Fluorescent in vivo tracking of hematopoietic cells. Part I. Technical considerations

We report a new technology for in vivo tracking of hematopoietic cells, using fluorescent lipophilic probes. Because the probe is irreversibly bound in the lipids of the cell membrane; substantial numbers of dye molecules can be incorporated per cell and thus substantial signal to noise can be achieved. Although this technology can be used for all hematopoietic cells, these first findings are reported on red blood cells (RBCs) owing to the importance of the membrane to RBC function and integrity. We demonstrated that labeling 10% of the RBCs of a rabbit and reinjecting them into the animal makes possible the tracking of these cells at various times after injection. Furthermore, the labeling appears not to affect in vivo cell lifetime or cellular volume changes in response to hypotonic shock. The single cell fluorescence intensity of the labeled RBCs remains relatively constant for 60 days, and an immune response appears not to be generated against labeled cells. That labeled RBCs have lifetime kinetics in vivo, as shown in other studies, indicates that the membranes are functioning normally and are unaltered by the labeling technology. The technology we present is also applicable to white blood cells, bone marrow, and platelets.     

Enhanced sensitivity of hippocampal pyramidal neurons from mdx mice to hypoxia-induced loss of synaptic transmission.

The gene at the Duchenne/Becker muscular dystrophy locus encodes dystrophin, a member of a protein superfamily that links the actin cytoskeleton to transmembrane plasmalemmal proteins. In mature skeletal myocytes, the absence of dystrophin is associated with decreased membrane stability, altered kinetics of several calcium channels, and increased intracellular calcium concentration. In the central nervous system, dystrophin is restricted to specific neuronal populations that show heightened susceptibility to excitotoxic damage and is localized in proximal dendrites and the neuronal somata. We report that CA1 pyramidal neurons in a hippocampal slice preparation from a dystrophin-deficient mouse genetic model of Duchenne muscular dystrophy (the mdx mouse) exhibit significant increased susceptibility to hypoxia-induced damage to synaptic transmission. This selective vulnerability was substantially ameliorated by pretreatment with diphenylhydantoin, an anticonvulsant that blocks both sodium-dependent action potentials and low-threshold transient calcium conductances. These findings suggest that dystrophin deficiency could predispose susceptible neuronal populations to cumulative hypoxic insults that may contribute to the development of cognitive deficits in Duchenne/Becker muscular dystrophy patients and that the effects of such periods of hypoxia may be pharmacologically remediable.