Prepartum, postpartum, and chronic depression effects on newborns

In order to assess the effects of the onset and chronicity of maternal depression on neonatal physiology, eighty pregnant women were assessed for depression during mid-pregnancy (M gestational age = 25.9 weeks) and shortly after delivery. The women were classified as reporting depressive symptoms 1) only during the prepartum assessment; 2) only during the postpartum assessment; 3) during both the prepartum and postpartum assessments; or 4) reporting no depressive symptoms at either the prepartum or the postpartum assessment. Maternal mood and biochemistry were assessed during pregnancy, and the EEG and biochemical characteristics of their 1-week-old infants were assessed shortly after birth. As predicted, the newborns of the mothers with prepartum and postpartum depressive symptoms had elevated cortisol and norepinephrine levels, lower dopamine levels, and greater relative right frontal EEG asymmetry. The infants in the prepartum group also showed greater relative right frontal EEG asymmetry and higher norepinephrine levels. These data suggest that effects on newborn physiology depend more on prepartum than postpartum maternal depression but may also depend on the duration of the depressive symptoms.     

Molecular characterization of arrestin family members in the malaria vector mosquito, Anopheles gambiae

Olfaction influences many insect behaviours including mate seeking and host selection. The molecular machinery underlying insect olfactory systems is a G protein-coupled receptor pathway that, in addition to activation, requires adaptation for olfactory sensitivity and discrimination. We have previously identified ARR1 (henceforth AgARR1), a sensory arrestin from the malaria vector mosquito Anopheles gambiae that has been postulated to modulate olfactory adaptation. This report describes three additional arrestin family members including ARR2 (henceforth AgARR2), which is similar to previously characterized insect sensory arrestins and is expressed at significantly higher levels in the antennae of male vs. female A. gambiae mosquitoes. This finding is consistent with the hypothesis that AgARR2 may be important for the regulation of olfactory-driven behaviours particular to male mosquitoes.     

Impact of digital labeling on outcome measures

OBJECTIVE: The purpose of this study was to determine whether the label attached to the hearing aid being presented would bias outcome measures towards newer technological designs. DESIGN: Two groups of subjects participated in this investigation. The groups were matched for age, gender, previous hearing aid experience, degree and configuration of hearing loss. Group A wore each of two digital hearing aids for 1 mo; Group B wore the same digital hearing aid for 2 mo, but the subjects were given the impression they were changing hearing aids after 1 mo. In each group the subjects were told that one of the months they were wearing a "digital" hearing aid and one of the months they were wearing a "conventional" hearing aid. Outcome measures consisted of a number of behavioral speech perception tasks and self-report measures, each completed at the onset and after 1 mo use with the hearing aids. RESULTS: Labeling effects were observed for many of the outcome measures. Using a mixed-model factorial analysis of variance to control for irrelevant variables and to explore interaction terms, prejudice (digital versus conventional labeling) was treated as a within-subject factor while the subject group (A or B) and clinician were treated as between-subject factors. Although only the APHAB RV and BN scales showed significant labeling effects on their own, the group of tests used in this study showed a significant labeling effect as a whole (p < 0.01). The total influence of labeling and related interaction terms indicated labeling-related effects accounted for 2 to 32% of the variance in individual outcome measures. DISCUSSION: The results of this investigation indicate a need for double-blinding in hearing aid research aimed at assessing the effectiveness of newer technologies, as well as a need for clinicians to critically evaluate the research describing the potential advantages of certain circuit options.     

Clinical significance of the umbilical cord twist

OBJECTIVE: The objective of this study was to determine the clinical significance of the umbilical cord twist direction. STUDY DESIGN: Two hundred singleton third-trimester placentas with a right umbilical cord twist and 200 placentas with a left umbilical cord twist, which was determined by pathologic examination, were included. Maternal and neonatal outcomes were compared with the use of Fisher's exact and Mann Whitney U tests; a probability value of <.05 considered statistically significant. RESULTS: Placenta previa was more common in patients with a right umbilical cord twist compared with a left umbilical cord twist (6.0% vs 1.5%; P<.05). There was a trend towards an increased incidence of single umbilical artery in patients with a right umbilical cord twist (2.5% vs 0%; P=.06). The incidence of fetal demise, intrauterine growth restriction, chromosomal abnormalities, congenital anomalies, preterm delivery, infant gender, birth weight, maternal age, and parity were similar between the 2 groups. CONCLUSION: Placenta previa is associated with a right umbilical cord twist.     

Clinical and radiological features of generalised lymphangiomatosis

We report a paediatric patient who presented with fever, shortness of breath, and vague abdominal discomfort. Lesions removed surgically proved to be generalised lymphangiomatosis and were treated conservatively. The spectrum of abnormalities and radiological features are discussed.     

Predictors of response to pharmacotherapy in social anxiety disorder: an analysis of 3 placebo-controlled paroxetine trials

BACKGROUND: There is increasing evidence that patients with social anxiety disorder (social phobia) respond to treatment with selective serotonin reuptake inhibitors (SSRIs). Response rates to SSRIs in social anxiety disorder have ranged from at least 50% in controlled trials to up to 80% in open trials. To date, however, there has been little information available about predictors of response to treatment in this disorder. METHOD: Data from 3 placebo-controlled multicenter trials of paroxetine in DSM-IV social anxiety disorder (N = 829) were analyzed using logistic regression to determine predictors of response. Demographic (age, sex), physiologic (baseline heart rate, baseline mean arterial pressure), clinical (baseline social anxiety symptom severity, baseline disability, duration of illness), and trial variables (paroxetine dose, treatment duration) were included. RESULTS: Only duration of treatment was a statistically significant predictor of treatment response. Further analysis demonstrated that, in paroxetine-treated patients in particular, many nonresponders at week 8 (46/166; 27.7%) were responders at week 12. CONCLUSION: These data demonstrate that paroxetine is a reasonable choice of treatment in a broad spectrum of patients with social anxiety disorder. An optimal trial of medication should continue beyond 8 weeks.     

Evaluation of attempted prevention of unexpected infant death in very high-risk infants by planned health care

Three hundred and ninety-six babies born in Sheffield between 1982 and 1990 identified as being at "very high risk" of unexpected infant death by means of a scoring system, received an intensive programme of health care including a case discussion between a paediatrician, the GP and the health visitor held in the family doctor's surgery, weekly visits from the health visitor and informal hospital admission. Significantly fewer sudden unexpected infant deaths occurred in this group than were expected by logistic regression anlysis or occurred in the best available control group with comparable scores ( p = 0.024). Problems in evaluation include identification of an adequate control population, ethical difficulties in introducing a controlled study when the programme is already perceived as effective, and the calculation of "expected death rates". The results of this study indicate that very energetic programmes of intervention may prevent some deaths in vulnerable infants.     

Physiological anticoagulants and activated protein C resistance in childhood stroke

Immunological and functional protein S, protein C and antithrombin III levels and anticoagulant responses to activated protein C were measured in 24 patients with stroke in childhood. No hereditary deficiencies were found. The protein S levels in healthy controls of younger age did not differ from the adult levels. For optimal screening of protein S deficiency, measurements using functional as well as immunological assays are recommended. Appropriate criteria for the diagnosis of the deficiencies must be carefully applied if unnecessary anxiety and inappropriate treatment of children are to be avoided.