New fluorogenic substrates for the study of secondary specificity of prolyl oligopeptidase

The secondary specificity of prolyl oligopeptidase (POP) has been studied by using a series of fluorogenic substrates containing the highly fluorescent 7-amino-4-methyl-2-quinolinone (AMeq) marker. The substrates were dipeptides of the general formula Z-X-Pro-NH-Meq, bearing amino acid residues with variable functional groups [Met, Lys(Boc). Lys. His, Ser, Leu, Glu(OMe), Glu, Cys(Bzl)] at the P₂ position, and the tripeptide Z-Asn-Cys(Bzi)-Pro-NH-Meq. The kinetic parameters for their hydrolysis by porcine kidney POP were determined at λ_ex= 360 nm and λ_em= 430 nm. All the dipeptide substrates showed a high affinity to the enzyme and could be used for its fluorometric determination. The S₂ binding subsite of POP can accomodate amino acid residues with a bulky side group, while it prefers a positively charged group (free Lys) instead of a negatively charged one (free Glu). © Munksgaard 1997.     

A household study of the pattern of utilization of mother and child health services in rural Greece and variation by socioeconomic status

Summary A household study of all families with children under 6 years in three villages in rural north-west Greece was conducted in August-September 1981. Ninety-four mothers were interviewed about each of their children to find out who they had consulted seeking advice and care during pregnancy, for delivery, in the post-natal period, for child immunization, and in cases of mild or severe child illness. All 142 children were examined physically and developmentally. Information was also collected on the socioeconomic status of the family. Particular causes for concern were the findings that 30% of the mothers said they had experienced at least one induced abortion; 5% had delivered without the help of any trained birth attendant; most of those who delivered in the district town (usually the better off) had received no postnatal care; 37% of children had not seen a doctor in their first year of life either for sickness or for a developmental assessment. Only 41% of children were fully immunized for their age, and 23% of those who should have started their immunizations had not begun. Most of the 30 children who had been severely or chronically ill had bypassed the local doctor and sought services in the district town. There was clear variation in the pattern of use of health services and socioeconomic status as shown by the availability of household facilities including water and electricity. The poorer mothers (30% of the sample) were more likely than the better-off mothers to have delivered at home. Many had had the help of the local midwife, but all those who had no help from a trained attendant came from the poorer families. Post-natal care was provided to most (79%) of these families, by the midwife. The poorer the family the more likely that a sick child would be treated with a home remedy. Children from poor families were likely never to have seen a doctor and if a child did go, it was likely to be older at the time of its first visit. Very few poor families had ever consulted a specialist. Mothers in a better-off situation were more likely to have delivered in the district town at a private clinic with a specialist obstetrician. They were unlikely to have received any post-natal care. Their children were likely to be younger when first taken to the doctor for a routine developmental check-up, usually in the first year of life. Home remedies were less likely to be used for child illnesses. It is suggested that the experienced rural community midwife is providing an excellent service to mothers from all social strata ante-natally; in delivery and post-natal care for poorer mothers, and in informal child care for everyone. She is well respected in the community and knows and is well known to all the children. It is suggested that the trend found for better-off mothers to go to the town for some private health services may undermine the crucial role the midwife has at the village level in rural Greece in pro-tecting the health of the poor and less educated mother.     

Birthweight Specific Perinatal Mortality in Greece

ABSTRACT. Data from the Greek Perinatal Study in April 1983 revealed an excessively high perinatal mortality rate of 21.6 per 1000 total births among singletons despite a low birthweight rate of only 4.5%. Comparison of perinatal mortality rates with Danish mortality rates in 1983, revealed the Greek rates to be three times higher than those in Denmark. When divided by time of death, the Greek stillbirth rates were two times higher and the early neonatal mortality rates were four times higher than the corresponding Danish rates. Subdivision of the Greek perinatal deaths using the Wigglesworth classification showed that the biggest group (40%) consisted of deaths associated with intrapartum asphyxia. The incidence of such deaths was 10 times higher than that found in Denmark. We conclude that in reducing the excessively high perinatal mortality rate in Greece special attention should be made to improve intrapartum and resuscitation techniques.