Maternal and perinatal outcome in preterm premature rupture of membranes

Background: Preterm premature rupture of membranes (PPROM) and preterm birth results in one third of perinatal mortality and maternal morbidity such as chorioamnionitis and abruption placenta and preterm caesarean section, Preterm premature rupture of membranes occurs in 3% of pregnancies. PPROM is associated with intrauterine infection. Early detection of intrauterine infection may help in prevent neonatal sepsis. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6 days and predict intrauterine infection by access the level of C reactive protein to prevent chorioamnionitis and neonatal infection.Methods: A descriptive study was conducted on 126 antenatal patients between 24 to 36 weeks+6 days with PPROM admitted to Department of Obstetrics and Gynaecology, Cheluvamba Hospital Mysore medical college, Mysore, Karnataka, India from February 2022 to July 2022. After establishing the diagnosis of PPROM patients were monitored and maternal and perinatal outcomes were studied.Results: 24% patients had late PPROM. 63% of early PPROM latency period >24 hours and were managed conservatively till 34 weeks. 18% had chorioamnionitis in that 12% CRP positive status and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period 24 hours and sepsis was 36% in >24 hours and 10% in <24 hours.Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. C-reactive protein helps to pick up chorioamnionitis early. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis.

Study of facial nerve F wave in patients with brainstem infarction / 中风与神经疾病杂志

@#ObjectiveTo study the dynamic changes of facial nerve F wave in patients with brainstem infarction，and to explore its value in diagnosis and prognosis evaluation of acute brainstem infarction. MethodsFifty-three patients with brainstem infarction were enrolled in our hospital. Electrophysiological examinations were performed on the 3rd，7th，14th，1st and 3rd days of onset，including the occurrence rate and latency of facial nerve F wave，and compared with the healthy side. Three months after onset，the patients were divided into good prognosis group（mRS≤2） and poor prognosis group（mRS>2） according to mRS neurological function score，and 10 healthy adults were included as control group with the same detection method. The incidence and latency of facial nerve F wave at different time points were compared. Results53 patients with brainstem infarction showed a decrease in the occurrence rate of f wave and an extension in the latency period on the 3rd，7th and 14th days of onset respectively，with a statistically significant difference compared with the healthy side（P<0.05）. However，the incubation period recovered at 3 months after onset，with no significant difference compared with the healthy side（P>0.05），while the occurrence rate was still statistically significant compared with the healthy side（P<0.05）. In patients with different types of brainstem infarction，the occurrence rate and incubation period of f wave in each group decreased to different degrees on the 3rd and 7th day，and the difference was not statistically significant（P>0.05）. The occurrence rate and incubation period of f wave in Raymond-Cestan syndrome group first recovered from the 14th day，with significant difference compared with other groups（P<0.05）. The occurrence rate and incubation period of f wave in Millard-Gubber syndrome group were higher than those in other groups at the 1st and 3rd month of onset，the difference was statistically significant（P<0.05）. On the 3rd and 7th day of onset，the incubation period and occurrence rate of f wave in the two groups increased and decreased，with no significant difference（P>0.05）. From the 14th day on，the incubation period and f wave occurrence in the group with good prognosis first recovered in the group with poor prognosis，with significant difference（P<0.05）. At the 3rd month of onset，the occurrence rate of F wave in the group with good prognosis was significantly higher than that in the group with poor prognosis，and the difference was statistically significant. However，the incubation period of the two groups had obvious recovery，and the difference was not statistically significant（P>0.05）. ConclusionThe changes of facial nerve F wave and latency can occur in patients with brainstem infarction in the early stage，but there is no differential diagnosis value for different types of cerebral infarction in the acute stage，which can provide valuable objective basis for prognosis evaluation after the acute stage.

Atualidade da neurose / Actuality of neurosis / Actualidad de la neurosis

O predomínio dos modelos ideais no momento de estabelecer as metas do trabalho psicanalítico leva a uma série de paradoxos, ou polaridades, apontada em 1965 por R. Wallerstein (existência/não existência de metas na análise, metas relativas ao processo/metas relativas aos resultados, visões otimistas/pessimistas sobre as metas). Estas polaridades são cotejadas com posições similares, existentes na mesma época no Rio da Prata (J. Bleger discutido por D. Liberman e C. A. Paz). A evolução posterior das ideias mostra a emergência de novas oscilações quando se tenta definir as metas a partir do conceito de processo psicanalítico. Ditas dificuldades sugerem a conveniência de prestar mais atenção à variedade de tratamentos que nós, analistas, realizamos em nossa prática real e aos resultados que efetivamente alcançamos neles. Estas ideias são examinadas a partir de um caso clínico cujo tratamento se afasta da análise clássica. Descrevem-se os diferentes tipos de metas que apareceram de forma progressiva para o analista durante as sessões e o papel que desempenharam. De modo mais geral, discute-se a natureza das metas dos tratamentos analíticos e a sua relação com as características do processo psicanalítico (AU)

This chapter VIII reviews the concept of neurosis in the 21st Century. Major concept of Freudian metapsychology based upon the discoveries of infantile sexuality and of infantile sexual theories, neurosis disappeared from the DSM in 2014. Infantile neurosis, transference neurosis, actual neurosis or narcissistic neurosis are concepts void of diagnostic value from the vantage point of the psychiatric nosography. Conflict between the Ego and the Id, as the economic balance between primary and secondary defense mechanisms, are no longer the major lenses to observe the psychic functioning. The author examines the influence of social and developmental modifications of the western 21st Century ­ such as the disappearance of the latency period, and the inflation of information concerning culture ­ on the situation of the concept of neurosis today. Taken out of its core situation, where Freud put it, neurosis is described as a situation of opposition in the concept of the 3rd type, placing neurosis opposite to not only perversion, but also to psychosis, or else, to psychopathy (AU)

El artículo hace un balance del concepto de neurosis en el siglo XXI. Concepto importante en la metapsicología freudiana desde el descubrimiento de la sexualidad infantil y las teorías sexuales infantiles, la neurosis desapareció en 2014 del repertorio del DSM. La neurosis infantil, la neurosis de transferencia, la neurosis actual o incluso la neurosis narcisista son conceptos vaciados de su valor diagnóstico desde el punto de vista de la nosografía psiquiátrica. El conflicto entre el Ego y el Ello, como el equilibrio económico entre los mecanismos de defensa primario y secundario, ya no son los ejes principales de observación del funcionamiento psíquico. La autora examina la influencia de los cambios sociales y de desarrollo en el siglo XXI occidental ­ como el fin del período de latencia y la inflación de información en relación con la cultura ­ sobre el estado actual del concepto de neurosis. Desplazada de la situación central en la que Freud la había colocado, la neurosis es descrita en una situación de polaridad en conceptos del tercer tipo que oponen la neurosis no solo a la perversión, sino también a la psicosis e incluso a la psicopatía (AU)

Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) analgesia at the latent stage of labor on epidural analgesia, labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia. METHODS: According to the random number table, 104 primipara of vaginal delivery were divided into three groups, named an EA group (37 cases), a sham-EA group (36 cases) and an epidural block group (31 cases). In the EA group, when the cervix opened up by 1 cm, Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu (LI4) and bilateral Sanyinjiao (SP6) to achieve EA analgesia till the active stage (the cervix up 3 cm). In the sham-EA group, the procedure was same as the EA group, but with the sham-stimulation. In the epidural block, EA was not used in intervention. When the cervix opened up 3 cm, the epidural block and the patient-controlled epidural analgesia were all adopted in each group. The score of visual analogue scale (VAS) and the dosage of Sufentanil and Ropivacaine in patient-controlled analgesia pump at the different time points were compared among the groups. Respectively, in 1 h of EA stimulation (T1), 2 h of EA stimulation (T2), at the moment of epidural block (T3) and the complete open of the cervix (T6), the venous blood sample was collected to determine the concentration of beta-endorphin (beta-EP), and the use time of oxytocin, the bleeding amount and the state of newborn were recorded. RESULTS: There was no statistical difference in immediate of EA stimulation (T0) among the groups in VAS score (P>0.05). But, in T1 to T6, VAS score in the EA group was reduced obviously as compared with the sham-EA group and the epidural block group separately (P0.05). In the sham-EA group and the epidural block group, bleeding amount during labor and in 24 h after labor was all higher than that of the EA group (P0.05). CONCLUSION: Electroacupuncture analgesia at the latent stage of labor effectively relieves labor pain of primipara, increases the concentration of beta-EP, enhances the effect of epidural block analgesia, reduces labor bleeding and has no side effect on newborn. The combination of electroacupuncture analgesia and the epidural anesthesia in the latent stage is applicable in the whole process of labor.

Micetismos: Parte 3: Síndromes tempranos gastrointestinales / Mycetisms Part 3: Early Gastrointestinal Syndromes

En esta Parte 3 de la serie de cuatro artículos sobre micetismos se analizan los síndromes tempranos con síntomas gastrointestinales que se caracterizan por presentar un período de latencia muy corto, de menos de 6 horas después de la ingestión de los macromicetos. Los restantes síndromes tempranos con sintomatología compleja serán tratados en la Parte 4 de la serie. Actualmente se conocen más de 200 especies responsables de síndromes gastrointestinales, pero en este trabajo se abordarán solamente diez ejemplos que involucran los géneros Boletus [Boletus satanas (o Rubroboletus satanas) y Boletus venenatus (o Neoboletus venenata)], Hypholoma, Agaricus (Agaricus xanthodermus), Omphalotus, Lactarius, Russula, Entoloma, Chlorophyllum (Chlorophyllum molybdetes) y Leucoprinus (Leucoprinus birnbaumii). Las toxinas involucradas en estos casos presentan gran variedad estructural, desde proteínas hasta terpenoides, en particular sesquiterpenoides y triterpenoides, vinilglicina, fenol y azocompuestos, pero todas generan la misma sintomatología. Estas sustancias y otros componentes químicos de los hongos suelen ser indigestos, con una susceptibilidad variable entre los consumidores. El tratamiento es de apoyo y es estrictamente para esos casos con cuadros más graves de deshidratación. Normalmente, los casos evolucionan favorablemente después de 12 a 48 horas. Se analizan los síntomas, las toxinas involucradas, los mecanismos de acción, cuando se conocen y las especies causantes de los micetismos.

This part 3 of the series of four articles on mushroom poisoning refers to early-onset gastrointestinal syndromes, which are characterized by a very short latency period of less than 6 hours after mushroom ingestion. The remaining early-onset syndromes with complex symptoms will be treated in Part 4 of the series. Currently, more than 200 species responsible for gastrointestinal syndromes are known, but in this paper only ten examples will be addressed involving the genera Boletus [e.g., Boletus satanas (or Rubroboletus satanas), and Boletus venenatus (or Neoboletus venenata)], Hypholoma, Agaricus (e.g., Agaricus xanthodermus), Omphalotus, Lactarius, Russula, Entoloma, Chlorophyllum (e.g., Chlorophyllum molybdetes), and Leucoprinus (e.g., Leucoprinus birnbaumii). The toxins involved in these cases have a great structural variety, from proteins to terpenoids, in particular sesquiterpenoids and triterpenoids, vinylglycine, phenol, and azocompounds, but all show the same symptoms. These substances and other mushroom chemical constituents are usually indigestible, with varying consumer susceptibility. The treatment is supportive and is strictly for those cases with more severe dehydration. Usually, the cases progress favourably after 12 to 48 hours.The symptoms, toxins involved, mechanisms of action when known, and the species of mushrooms responsible for the mycetisms are analysed.

Nesta parte 3 da série de quatro artigos sobre intoxicação por cogumelos são analisadas as síndromes precoces com sintomas gastrointestinais que se caracterizam por apresentar um período de latência muito curto, de menos de 6 horas, após a ingestão de cogumelos. As síndromes precoces restantes com sintomatologia complexa serão tratadas na Parte 4 da série. Atualmente, são conhecidas mais de 200 espécies responsáveis por síndromes gastrointestinais, mas neste trabalho serão abordados apenas dez exemplos que envolvem os gêneros Boletus [Boletus satanas (ou Rubroboletus satanas) e Boletus venenatus (ou Neoboletus venenata)], Hypholoma, Agaricus (Agaricus xanthodermus), Omphalotus, Lactarius, Russula, Entoloma, Chlorophyllum (Chlorophyllum molybdetes) e Leucoprinus (Leucoprinus birnbaumii). As toxinas envolvidas nestes casos têm uma grande variedade estrutural, desde proteínas até terpenóides, em particular sesquiterpenóides e triterpenóides, vinilglicina, fenol e azo compostos, mas todas apresentam a mesma sintomatologia. Essas substâncias e outros constituintes químicos dos cogumelos costumam ser indigestos, com uma suscetibilidade variável entre aqueles que os consomem. O tratamento é de suporte e é rigorosamente para esses casos com quadros mais graves de desidratação. Normalmente, os casos evoluem favoravelmente após 12 a 48 horas. São analisados os sintomas, as toxinas envolvidas, os mecanismos de ação, quando conhecidos, e as espécies de cogumelos responsáveis pelas intoxicações.

Induced breeding of Catla catla carried out at low temperature in FRP carp hatchery of Arunachal Pradesh, India

Aim: The present study was undertaken to find out the possibilities of induced breeding of Catla catla, at low water temperature using fibre reinforced (FRP) tanks in a carp hatchery. Methodology: Brood fish of C. catla was maintained in 0.1 ha pond with proper feeding and pond management. Six induced breeding programmes: 3 in April (pre-monsoon) and 3 in June (monsoon) of 2017 were conducted with C. catla using synthetic hormone, Ovasis intra-peritoneally. The relationship between temperature variation and latency period, effective spawning period, fecundity, hatching start time, hatching duration and spawn production with its recovery was observed. Results: The latency period (time gap between injection and first egg release) was very high and ranged between 653.3 and 721.6 min for breeding in the pre-monsoon and ranged between 446.6 and 480 min for monsoon period. In pre-monsoon, the effective spawning period between 86.6 and 116.6 min and in monsoon between 53.3 and 73.3 min; both varied significantly (p˂0.05). In pre-monsoon period, the average water temperature during larval incubation in hatching pool ranged between 21.58 and 22.58ºC, whereas during monsoon period it ranged between 30.1 and 30.4ºC. The spawn production was 0.13 to 0.22; and 0.47 to 0.65 (lakh kg-1 b. wt. of female) in pre-monsoon and monsoon period, respectively, and showed a significant difference (p˂0.05). Interpretation: This report on breeding of C. catla in the temperature range of 18.6-24.7oC indicates the possibility of spawn production of Indian Major Carp in the north east hilly region states of India

Effect of preemptive electroacupuncture on pain reactions in primiparous parturients during vaginal delivery / 针刺研究

OBJECTIVE: To investigate the effect of preemptive electroacupuncture (EA) plus epidural block (EB) on pain reactions and stress hormone levels in primiparous parturients during labor. METHODS: A total of 104 primiparous parturients undergoing vaginal delivery were randomly divided into PA group (n=31), sham EA group (n=36) and EA group (n=37). EA (2 Hz/100 Hz, a tolerable strength) was applied to bilateral Hegu (LI4) and Sanyinjiao (SP6) beginning from the latency of the 1st birth process when the orifice of uterus was opened to about 1 cm wider till the active stage when the orifice of the uterus opened about 3 cm wider. Patients in the sham EA group received shallow acupuncture needle stimulation (without cutaneous penetration of the needle tip, and without stimulation electric current output). All the patients of the 3 groups were given EB (1% Lidocaine, 0.05% Sufentanil and 0.1% Ropivacaine) and patient-controlled epidural analgesia (PCEA) when the orifice of the uterus opened about 3 cm wider. The pain severity was assessed by using Visual Analogue Scale (VAS) at time-points of immediately after EA, 1 h after EA, 2 h after EA, immediately after EB, 1 h after EB, 2 h after EB and full open of the uterus orifice. The contents of serum adrenocorticotrophic hormone (ACTH) and cortisol (COR) were assayed by using ELISA. RESULTS: There was no significant difference in the VAS score at the immediate time of post-EA among the three groups (P>0.05). Compared with the EB group, the VAS scores at all time-points except the immediate time of post-EA were significantly decreased in the EA group (P<0.05). One and 2 h after EB, and after full open of the uterus orifice, the VAS scores in the 3 groups were all evidently decreased (P<0.05), and those of the EA group were significantly lower than those of the sham EA and EB groups (P<0.05). The three groups had a significant increase in the levels of serum ACTH and COR at time-points of 1 and 2 h after EA, immediately after EB, and when the orifice of the uterus was fully opened (P<0.05), presenting a gradual increase of their level during the course of labor. Compared with the EB group, the levels of serum ACTH and COR contents were considerably decreased in the EA group (rather than in the sham EA group) (P<0.05). The dosages of Ropivacaine and Sufentanil, the total pressing times and the effective pressing times of PCEA pump were significantly lower in the EA group than those in the EB and sham EA groups (P<0.05). CONCLUSION: EA plus epidural analgesia, given during the latency period of labor, can effectively alleviate pain, inhibit stress response and reduce the dosage of anesthetics in primiparous parturients throughout the labor process.

Duration of Preterm Premature Rupture of Membranes as Predictor of Histologic Chorioamnionitis and Early Onset Neonatal Sepsis: A cohort study

Background@#Preterm premature rupture of membranes (PPROM) has been associated with chorioamnionitis but studies are inconsistent on the relationship between PPROM latency and the risk of chorioamnionitis and early onset sepsis.@*Objective@#To define the association of PPROM latency and the risk of histologic chorioamnionitis (HCA) and early onset neonatal sepsis (EONS). @*Methodology@#A prospective cohort study was done at a public tertiary hospital on 569 mothers with spontaneous rupture of membranes and with fetuses EONS was defined using test of association and Receiver Operating Characteristics (ROC) curve analysis. The association of HCA with maternal and neonatal characteristics as well as adverse neonatal outcomes were also determined. @*Results@#A total of 569 mothers with PPROM were included. Incidence of HCA and EONS were 13% and 24% respectively. PPROM latency was significantly associated with HCA and is a fair predictor of HCA (AUC = 0.7013; 76% accuracy at 31.5-hour cut-off) but failed as a predictor of EONS (AUC = 0.4799). PPROM, platelet count, CRP, and neutrophil count were ndependent predictors of HCA. HCA was associated with EONS and mortality. Mortality was higher in the presence of both HCA and EONS. @*Conclusion@#Longer PPROM is associated with HCA and is a fair predictor of HCA at a cut-off of 31.5 hours. PPROM fails as a predictor of EONS.

Micetismos: Parte 1: Síndromes con período de latencia tardía / Mushroom poisonings: Part 1: late-onset syndromes / Intoxicações por cogumelos: Parte 1: Síndromes com tempo de latência tardia

Los hongos son de valor nutricional, organoléptico y comercial, pero también contienen sustancias tóxicas que dan lugar a micetismos, cuyo tratamiento requiere el conocimiento del toxíndrome para poder lograr el tratamiento adecuado. En esta serie de cuatro artículos se clasifican los micetismos en base al período de latencia, que es el tiempo transcurrido desde la ingestión hasta la aparición de los síntomas, en intoxicaciones tardías, demoradas o retrasadas y tempranas o precoces. En esta parte 1 se analizan los siguientes síndromes con latencia tardía: a) Hepatotóxico o por ciclopéptidos (micetismo por amatoxinas). b) Nefrotóxico (micetismo por Amanitas nefrotóxicas). c) Eritromelalgia (micetismo por especies de Clitocybe). d) Neurotóxico epileptogénico (micetismo por giromitrina). e) Cerebeloso (micetismo por Morchella spp.). f) Encefalopático o neurotóxico tardío (micetismo por Hapalopilus rutilans). La toxicidad tardía engloba los síndromes potencialmente más graves, cuyos síntomas surgen entre 6 y 24 horas después de la ingestión. Para cada síndrome se da a conocer el tiempo de latencia, la sintomatología, las toxinas y el mecanismo de acción (cuando se conocen), y por último las especies de macromicetos involucradas. A veces, si es necesario, se discute la toxicodinamia y las metodologías de análisis. En la última sección se discuten los tratamientos generales, y más en detalle, los tratamientos para contrarrestar los micetismos debidos a amatoxinas y a giromitrina, que han sido los más estudiados de todos los analizados en esta parte 1. Esta información es considerada de valor para el conocimiento de los bioquímicos clínicos, así como de médicos toxicólogos y personal de salud de unidades de emergencia.

Mushrooms are of nutritional, organoleptic and commercial value, but they also contain toxic substances that give rise to the so-called mushroom poisoning (mycetism), whose medical management requires knowledge of the toxin in order to achieve the appropriate therapy. In this series of three articles, mushroom toxidromes are classified based on the latency period, which is the time elapsed from ingestion to the onset of the symptoms, in late, delayed-, and early-onset intoxications. In this part 1, the following late-onset syndromes are analyzed: (a) Hepatotoxicity or cyclopeptide syndrome due to amatoxins. (b) Nephrotoxicity or Amanita nephrotoxic syndrome. (c) Erythromelalgia (mycetism due to Clitocybe species). (d) Epileptogenic neurotoxicity or gyromitrinic syndrome. (e) Cerebellar syndrome due to Morchella spp. and (f) Late encephalopathic or neurotoxic syndrome due to Hapalopilus rutilans. Late toxicity comprises potentially more severe syndromes, whose symptoms appear between 6 and 24 hours after ingestion. For each syndrome, latency time, symptomatology, toxins, and the mechanism of action (when known) are analyzed, together with the species of macromycetes involved. Sometimes, if necessary, toxicodynamics and methodologies of analysis are displayed. The last section discusses in general mushroom poisoning management, and in detail, the therapy to counteract mycetism due to amatoxins and gyromitrin, which have been the most widely studied of all mushroom poisonings analyzed in this part 1. This information is considered valuable for the knowledge of clinical biochemists, as well as of medical toxicologists, and health staff of emergency units.

Os cogumelos são de valor nutricional, organoléptico e comercial, mas também contêm substâncias tóxicas que dão origem às intoxicações por cogumelos (micetismos), cujo tratamento requer o conhecimento da toxíndrome a fim de alcançar a terapia apropriada. Nessa série de três artigos, as intoxicações por cogumelos são classificadas com base no período de latência, que é o tempo decorrido desde a ingestão até o início dos sintomas, em intoxicações tardias, demoradas ou retardadas e precoces. Nessa parte 1, são analisadas as seguintes síndromes de latência tardia: (a) Hepatotóxica ou por ciclopeptídeos (intoxicações por amatoxinas). (b) Nefrotóxica (intoxicação por Amanitas nefrotóxicas). (c) Eritromelalgia (micetismo por espécies de Clitocybe). (d) Neurotóxica epileptogênica (intoxicação por giromitrina). (e) Cerebelar (intoxicação por Morchella spp. f) Encefalopática ou neurotóxica tardia (micetismo por Hapalopilus rutilans. Toxicidade tardia abrange as síndromes potencialmente mais graves, cujos sintomas aparecem entre 6 e 24 horas após a ingestão. Para cada síndrome, o tempo de latência, a sintomatologia, as toxinas e o mecanismo de ação (quando conhecidos) são dados a conhecer, juntamente com as espécies de macromicetos envolvidos. Às vezes, se necessário, a toxicodinâmica e as metodologias de análise são discutidas. A seção final discute os tratamentos gerais e, mais detalhadamente, os tratamentos para a abordagem terapêutica dos micetismos por amatoxinas e giromitrina, que têm sido os mais estudados de todos os analisados nessa parte 1. Essa informação é considerada de valor para o conhecimento dos bioquímicos clínicos, bem como para médicos toxicologistas e pessoal de saúde das unidades de emergência.

Gray mold in immature fig fruit: pathogenicity and growth temperature / Mofo cinzento em frutos imaturos de figo: patogenicidade e temperatura para crescimento

ABSTRACT: Several diseases can be associated with figs but recently a fruit rot was observed in green fruit. The purpose of this study was to determine the pathogenicity of Botrytis sp., to quantify incubation period (IP) and latent period (LP), to verify the optimum temperature for mycelial growth, and to identify the different species of Botrytis sp. isolated from immature figs. Botrytis sp. isolated from figs proved to be pathogenic to immature fruit with and without wounding the fruit surface and ostiole. The IP period was 3 days on fruit with wounds and 5 days on fruit inoculated within the ostiole (without wound). The LP was 6 days in all treatments. The optimum temperature for mycelial growth was 18°C. Inferred from sequences of a segment comprising the ITS region of ribosomal DNA concluded that the isolates are Botrytis cinerea.

RESUMO: Várias doenças podem estar associadas com figos, mas recentemente uma podridão dos frutos foi observada em frutos verdes. O objetivo deste estudo foi determinar a patogenicidade de Botrytis sp., quantificar o período de incubação (PI) e o período de latência (PL), verificar a temperatura ótima para o crescimento micelial e identificar as diferentes espécies de Botrytis sp. isoladas a partir de frutos imaturos de figo. Botrytis sp. isolado a partir de figos provou ser patogênico em frutos imaturos com e sem ferimento na superfície dos frutos e no ostíolo. O PI foi de 3 dias em frutos com ferimento e 5 dias em frutos inoculados no ostíolo e sem ferimento. O PL foi de 6 dias em todos os tratamentos. A temperatura ótima de crescimento micelial foi18°C. A partir de sequências de um segmento que compreende a região de ITS do DNA ribossomal, concluiu-se que os isolados são Botrytis cinerea.

Sobre o destino das pulsões sexuais nos jovens atuais: vicissitudes da latência à adolescência / About sexual drives in todays youngsters: vicissitudes from latency period to adolescence / Sobre el destino de las pulsiones sexuales en los jóvenes actuales: vicisitudes de la latencia a la adolescencia

No presente trabalho, os autores refletem sobre a influência da cultura atual nos processos de desenvolvimento da latência e da adolescência. Sugerem a presença, nos pais, de componentes narcísicos não elaborados, o que interfere na elaboração edípica dos filhos e dificulta, nestes últimos, sua inserção em um mundo triangular. Assim, é perturbada também a passagem dos filhos pela latência, período do desenvolvimento em que deve se consolidar o processo repressivo e que culmina com a estruturação do superego. Tais aspectos, somados às características da cultura contemporânea, em que as diferenças entre os sexos e as gerações estão esmaecidas e em que há uma descrença na autoridade, reforçam uma fantasia de controle onipotente do mundo. Em função desses aspectos, a clínica atual denota que os adolescentes encontram dificuldades ainda maiores para lidar com a complexidade de sua conflitiva, cuja elaboração permitirá um ingresso adequado no mundo adulto.

In this paper, the authors discuss the influence of today's culture on the processes of development of the latency period and adolescence. They suggest that there are non-elaborated narcissistic components in the parents which interfere in the child's Oedipal elaboration, raising difficulties in their insertion in a triangular world. This also disturbs the passage of the children through the latency period, a phase of development in which the repressive process should be consolidated and which culminates with the structuring of the superego. These aspects, together with characteristics of contemporary culture, in which differences among genders and generations fade away, and there is a disbelief in authority, strengthen the fantasy of having an omnipotent control of the world. Considering all these aspects, the contemporary clinic evidences that today's adolescents face greater difficulties when dealing with the complexity of their conflicts, the elaboration of which will allow an adequate entrance into the adult world.

En el presente trabajo, los autores reflexionan sobre la influencia de la cultura actual en los procesos de desarrollo de la latencia y adolescencia. Sugieren la presencia, en los padres, de componentes narcisistas no elaborados, que interfieren en la elaboración edípica de los hijos y les dificulta la inserción en un mundo triangular. Así, también el pasaje de los hijos por la latencia es perturbado, periodo de desarrollo en que se debe consolidar el proceso represivo y que culmina con la estructuración del superego. Esos aspectos, unidos a las características de la cultura contemporánea, en que las diferencias entre los sexos y las generaciones están desvanecidas y se descree en la autoridad, refuerzan la fantasía de control omnipotente del mundo. En función de estos aspectos, la clínica actual denota que los adolescentes encuentran dificultades todavía mayores para lidiar con la complejidad de su conflictiva, cuya elaboración permitirá un ingreso adecuado en el mundo adulto.

Antinociceptive and Antioxidant Activity of an Aqueous Root Bark Extract of Daniellia oliveri (Rolfe) Hutch. & Dalziel (Fam: Leguminosae [Fabaceae]) in ICR Mice.

Daniellia oliveri stem bark is used traditionally by the people of Northern Ghana to manage pain. This study therefore sought to validate the antinociceptive property of an aqueous stem bark extract of Daniellia oliveri (DOE) using murine hot plate and paw pressure pain models as well as its antioxidant property. Groups of ICR mice were pre-treated with DOE (250, 500, 1000 or 2000 mg kg-1 , p.o), morphine (3 mg kg-1 , i.p), diclofenac (3 mg kg-1 , i.p) or normal saline (2 ml/kg) respectively for 0.5 - 1 h, prior to pain induction. Pain latency period were measured at 0.5 h intervals for 1.5 h. To establish the possible mode of analgesic activity, nociceptive activity of DOE was antagonized by naloxone (2 mg kg-1), glibenclamide (8mg kg-1), and theophylline (5mg kg1). The extract was screened for antioxidant property by its effect on DPPH radical scavenging activity. DOE in both pain models produced significant (P ≤ 0.001) dose and time - dependent antinociceptive effect comparable to morphine, and diclofenac. The antinociceptive effect of DOE was significantly (P ≤ 0.001) attenuated by naloxone, glibenclamide, and theophylline. DOE caused a concentration dependent percentage increase in DPPH radical scavenging activity. The aqueous stem bark extract of Daniellia oliveri therefore has antinociceptive and antioxidant effect with antinoception possibly mediated through activation of ATP-sensitive potassium channels, as well as opioidergic and adenosinergic receptor pathways.

Interventions and Neonatal Outcomes in Patients with Premature Rupture of Fetal Membranes at and Beyond 34 Weeks Gestational Age at a Tertiary Health Facility in Nigeria.

Aims: To compare the neonatal outcome in patients with PROM at and beyond 34 weeks, who had expectant management and progressed to spontaneous labour and those who had induction of labour. Study Design: Retrospective study of patients presenting with PROM at and beyond 34 weeks gestation over a 3 year period. Place and Duration of Study: Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria, between July 2007 and June 2010. Methodology: Case files of 92 patients with PROM and live, singleton fetuses, at and beyond 34 weeks gestation, in the study period, were retrieved from the hospital Health Records Department, collated and analyzed. Data collected included parity, estimated gestational age (EGA) at PROM, latency period (time interval from PROM to onset of labour), intervention following PROM, eventual mode of delivery and neonatal outcome. Results: A total of 2340 deliveries were recorded in the study period and 92 cases of PROM were on record for the period. However, only 74 PROM cases were included in the study, due to incomplete information. Incidence of PROM was therefore 3.9%. Length of latency period had a direct influence on the number of patients that went into spontaneous labour (P = 0.012) and subsequent vaginal delivery (P = 0.021). Induction of labour did not increase rate of caesarean section (P = 0.449) and had no effect on neonatal outcome (P = 0.239). Conclusion: Acceptable approach for the management of PROM at and beyond 34 weeks would be expectant management for the 1st 24 hours and induction of labor afterwards in patients who have not progressed into spontaneous labour. Expectant management in the extended latency period in the late preterm PROM group is associated with increased NICU admission (OR 7.33, 95% C.I 2.45 – 21.98); however, this did not affect duration of NICU stay or neonatal mortality.

Período de latência e tempo para compreender nas aprendizagens / Latent phase and time for understanding in learning / Periodo de latencia y tiempo para comprender en al acto del apredizaja

O artigo aborda a dimensão do período de latência e do tempo para compreender nas aprendizagens. Argumenta que, a partir de Lacan (1959), se de um lado a inibição neurótica pode ser lida como uma paralisação no tempo para compreender, de outro é possível concluir que a inibição estrutural diz de uma vivência própria do tempo para compreender, nas aprendizagens, a qual antecede e apoia o conclusivo ato de aprender e o usufruto dessa aprendizagem. Para tal argumento, o artigo extrai consequências da abordagem da latência dada por Freud (1939) em "Moisés e o monoteísmo", argumentando que a latência se aproxima do tempo para compreender do qual nos fala Lacan (1946).

This article discusses the role played by the latency period and time for understanding in learnings. The authors posit that from Lacan (1959), if on the one hand, the neurotic inhibition can be taken as a paralyzation in the time for understanding, on the other hand, it is possible to conclude that the structural inhibition reveals a intrinsic experience of the time for understanding, in learnings. Structural inhibition whichs antecedes and supports the conclusive act of learning and its usufruct. For such an argument, this article extracts consequences from the latency period approached by Freud (1939) in "Moses and monotheism", claiming that the latent phase becomes closer to the time for understanding approached by Lacan (1946).

El artículo analiza la dimensión del período de latencia y del tiempo para comprender en el acto del aprendizaje. Sostiene (Lacan, 1959) que, si por un lado la inhibición neurótica puede leerse como una paralización en el tiempo para comprender, por otro lado es posible concluir que la inhibición estructural de una vivencia propia del tiempo para comprender, en los aprendizajes. Vivencia que precede y apoya el concluyente acto del aprendizaje, así como el usufructo de ese aprendizaje. Para esgrimir tal argumento, el artículo extrae consecuencias de la aproximación al concepto de latencia en la obra "Moisés y el monoteísmo" de Freud (1939), argumentando que la latencia se aproxima al tiempo para entender lo que dice Lacan (1946).

Enfermedades pulmonares no malignas entre obreros del cemento-asbesto en Brasil: un estudio de prevalencia / Non-malignant pulmonary diseases among asbestos cement workers in Brazil: a prevalence study

A pesar del impacto social y económico, las enfermedades pulmonares no malignas relacionadas con el asbesto han sido subestimadas. Las alteraciones radiológicas y la disminución de la capacidad pulmonar suceden tardíamente, años después de abandonar el trabajo. Es fundamental aclarar la alta prevalencia de las enfermedades que conlleva las lesiones físicas y sociales. Realizamos un estudio de prevalencia en 145 personas seleccionadas al azar de una población de 2.124 ex obreros que habían trabajado en una fábrica de fibrocemento entre 1983 y 1993. El criterio de elegibilidad de la muestra fue la latencia en el transcurso de 20 años entre la primera exposición y la recopilación de datos. Se realizaron cuestionarios sobre ocupación y respiración, examen físico, prueba de función pulmonar y radiografía. La prevalencia de las enfermedades pulmonares no malignas relacionadas con el asbesto fue del 39,3 por ciento considerando las alteraciones radiológicas. Ha habido una asociación importante entre el tiempo trabajado y las placas pleurales (p < 0,001), asbestosis (p = 0,05) y las enfermedades pulmonares no malignas (p < 0,001). Existe una relación importante entre la dosis de exposición con las placas pleurales (p = 0,0001) y la asbestosis (p = 0,0005). La latencia fue un factor sumamente importante para la asbestosis (p = 0,037-OR 21,1)y las enfermedades pulmonares no malignas (p < 0,001-OR 2,1). Como conclusión, ha habido una alta prevalencia de enfermedades pulmonares no malignas relacionadas con el asbesto entre exobreros de fibrocemento. Según los resultados, se destacan un aumento relacionado con la latencia, la exposición de la dosis y el tiempo trabajado.

In spite of the social and economic impact, non-malignant pulmonary diseases related to asbestos have been undervalued. Radiological alterations and decrease of pulmonary capacity happen belatedly after years that leave the job. It is fundamental to clarify the high prevalence that carry for physical and social prejudices. We performed a prevalence survey in 145 people randomly selected from a population of 2.125 former workers that had been worked in a fiber cement factory between 1983 and 1993. The eligible criteria of sample were latency over 20 years between first exposure and data collection. Occupational and breathing questionnaire, physical exam, pulmonary function and X-ray were performed. The prevalence of non-malignant pulmonary diseases related to asbestos was 39,3percent considering radiological alterations. There has been a significant association between time work and Pleural Plaques (p < 0,001), Asbestosis (p = 0,05) and non-malignant pulmonary diseases (p < 0,001). An important relationship between exposure dose with Pleural Plaques (p = 0,0001) and Asbestosis (p = 0,0005). Latency was a highly significant to Asbestosis (p = 0,037-OR 21.1) and non-malignant pulmonary diseases (p < 0,001-OR 2.1). Concluding, there has been a high prevalence of non-malignant pulmonary diseases related to asbestos among fiber cement former workers and results highlight an increase related to latency, dose exposure and time work.

Medición del ciclo sueño-vigilia en trabajadores de la gran minería del cobre / Measurement of the sleep-wakefulness cycle in workers from large-scale copper mining

El único período de tiempo en que el ser humano recupera la energía del desgaste corporal de las actividades cotidianas es durante el sueño. Una forma de medir el ciclo sueño-vigilia es usando un dispositivo que se llama actígrafo, el que, por medio de gráficos llamados actogramas, demuestra indirectamente el ciclo sueño-vigilia. Método: Se realizó una medición del ciclo sueño-vigilia a 44 trabajadores de la gran minería del cobre en Chile, por medio del registro de 11 días consecutivos, de los cuales 7 eran en su casa y 3-4 en el trabajo. Se compararon las variables latencia, tiempo y eficiencia de sueño en cada individuo en su período de trabajo y descanso. Luego se comparó todas las variables según grupos etarios (de edad menor o mayor a 40 años). Resultados: No se demostró diferencias significativas en las variables de eficiencia de sueño en todos los trabajadores en las dos condiciones y en los dos grupos etarios. Se observa una menor latencia de sueño en el grupo de menos de 40 años en el período de descanso. Además, el tiempo de sueño en el período de trabajo en los dos grupos es menor, siendo estadísticamente significativo en el grupo menor a 40 años. También se observa que un 30 por ciento de los trabajadores no tiene un período adecuado de descanso previo a su jornada laboral debido al tiempo de traslados en distancias prolongadas. Conclusión: El estudio demostró que los trabajadores duermen menos horas en su jornada de trabajo en comparación al periodo de descanso; además, que no tienen un descanso adecuado durante el tiempo de traslado al inicio de su período de trabajo. Estos factores pueden ser relevantes en la sensación de fatiga en estos tipos de trabajadores en los primeros días de su turno de trabajo.

The sleeping time is the only period of time in which the human being recovers the energy that has been lost due to everyday activities. The sleep-wakefulness cycle can be measured by using an actigraph, a device showing indirectly this cycle by means of graphs called actograms. Method: A measurement of the sleep-wakefulness cycle was carried out in 44 workers from a large-scale copper mining company in Chile. Eleven consecutive days were registered; workers were at their home seven days and at work between three and four days. Variables of latency, sleep time and efficacy were compared in each subject during work and rest times. Later, all the variables for different age groups (under or over 40 years) were compared. Results: In all workers, no significant differences were identified in the variables of sleep efficacy in both conditions and both age groups. It can be observed a lower latency in the group under 40 years during resting time. Moreover, sleep hours during working time in both groups is low, which is statistically significant in the group under 40 years. It is also observed that 30 percent of workers do not have an adequate resting time prior to their working time because they spent considerable time traveling great distances to the workplace. Conclusion: The study showed workers sleep few hours in working time in comparison to resting time; besides, they do not have an appropriate resting time during the trip at the beginning of the work time. These factors can be important in the workers fatigue sensation during the first days of their work shift.

Is palatal injection mandatory prior to extraction of permanent maxillary tooth: A preliminary study.

Introduction: Even after the invention of the modern injection techniques, palatal injection still remains a painful experience for patients, and this pain is attributed to the presence of rich nerve complement and displacement of palatal mucosa during anesthesia. Objective: The aim of the present study was to demonstrate if lidocaine HCl could provide palatal anesthesia if given buccally during maxillary tooth removal without the need for a palatal injection. Materials and Methods: The study group consisted of 75 patients, and 25 were controls. All the patients in the study group had unilateral extractions. In 75 patients, 2 ml of 2% lidocaine HCl with 1:80,000 epinephrine was injected into the buccal vestibule of tooth indicated for extraction without palatal injection. After 8 min, the extraction of maxillary tooth was carried out. Twenty-five subjects in the control group underwent same protocol with palatal injection. All the patients completed a faces pain scale (FPS) and a 100 mm visual analog scale (VAS) after extraction. Statistical Analysis Used: Unpaired t test and Chi-square test. Results: According to VAS and FPS scores, when comparison was carried out between permanent maxillary tooth removal with and without palatal injection, the difference in the pain levels were not statistically significant (P>0.05). Conclusion: The extraction of permanent maxillary tooth is possible by depositing 2 mL of lidocaine to the buccal vestibule of the tooth without the need for palatal anesthesia.

Reflexões de uma psicanalista sobre a criança na sociedade ocidental de hoje / Reflexiones de una psicoanalista sobre el niño en la sociedad occidental de hoy / Reflections of a psychoanalyst on children in today’s western society

Este trabalho investiga as consequências das mudanças estruturais na sociedade ocidental, focando no impacto da tecnologia de comunicação e estruturas familiares cada vez mais frágeis. Descreve a dissolução de relações sociais e relações humanas íntimas, que acredita-se estejam sofrendo um processo de de-simbolização. Esta erosão das relações humanas confronta os indivíduos com novas demandas no aspecto econômico de seus instintos pulsionais e com novas formas de ansiedade. A autora argumenta que a globalização da comunicação virtual muda radicalmente a conexão com a realidade e a verdade e que o risco de mentalidade de grupo, em contraste com responsabilidade pessoal está aumentado. É colocada ênfase especial no desaparecimento do período de latência na sociedade contemporânea. Para Freud o período de latência – há cem anos – era baseado no desenvolvimento sexual difásico, repressão e Nachtrãglichkeit, alicerces da elaboração de sua teoria de neurose infantil e neurose transferencial. O trabalho discute as consequências das mudanças contemporâneas para a clínica e teoria hoje, assim como o impacto destas mudanças na transferência/contratransferência no tratamento analítico de crianças e adolescentes

This paper investigates the consequences of the structural changes in western society by focussing on the impact of communication technology and increasingly fragile family structures. It describes the dissolution of social relations and intimate human relationships, which are thought to undergo a process of de-symbolization. This undermining of human relationships is supposed to confront individuals with new demands on the economic aspect of their instinctual drives and with new kinds of anxiety. The author argues that the globalization of virtual communication radically changes the connection with reality and truth, and that the risk of “group mentality” in contrast to personal responsibility is increased. Special emphasis is given to the vanishing of the latency period in contemporary society. For Freud the latency period – a hundred years ago – was the basis of diphasic sexual development, repression and Nachtrãglichkeit, which his theory of infantile neurosis and transference neuroses was built upon. The paper discusses the consequences of the contemporary changes for clinical work and theory today as well as the impact of these changes on the transference/counter-transference situation in the analytical treatment of children and adolescents

Este trabajo investiga las consecuencias de los cambios estructurales en la sociedad occidental, enfocando el impacto de la tecnología de comunicación y estructuras familiares cada vez más frágiles. Describe la disolución de relaciones sociales y relaciones humanas íntimas que se considera sufran un proceso de desimbolización. Esta erosión de las relaciones humanas enfrenta a los individuos a nuevas demandas en el aspecto económico de sus instintos pulsionales y a nuevas formas de ansiedad. La autora argumenta que la globalización de la comunicación virtual cambia radicalmente la conexión con la realidad y la verdad, y que el riesgo de “mentalidad de grupo”, en oposición a responsabilidad personal está en aumento. Se subraya especialmente el desaparecimiento del periodo de latencia en la sociedad contemporánea. Para Freud, el periodo de latencia – hace cien años – se basaba en el desarrollo sexual difásico, represión y Nachtrãglichkeit, cimientos de la elaboración de su teoría de neurosis infantil y neurosis transferencial. El trabajo discute las consecuencias de los cambios contemporáneos para la clínica y teoría hoy, así como el impacto de estos cambios en la transferencia/contratransferencia en el tratamiento analítico de niños y adolescentes

Clinical outcome of preterm premature rupture of membranes in singleton versus twin pregnancy / 대한산부인과학회지

OBJECTIVE: To compare the latency period and perinatal outcome of singleton and twin pregnancies complicated by preterm premature rupture of the membranes (PPROM). METHODS: From January 1996 to December 2005, the medical records of women with singleton (n=345) and twin pregnancies (n=73) complicated by PPROM (24-34 weeks of gestation) were reviewed. Pregnancy and neonatal outcomes including the latency period, neonatal morbidity, and mortality were compared between the singleton and twin groups. RESULTS: No differences were noted with respect to gestational age at the time of membrane rupture and use of tocolytics, steroid and prophylactic antibiotics between the two groups. The latency period was significantly shorter in twins (median [range]; 4.0 [0-50] day vs. 1.0 [0-25] days, p<0.001), and significantly more twins were born within 48 hours and within 7 days after rupture of the membranes (within 48 hours, 33.0%vs. 65.8%, p<0.001; within 7 days, 67.5%vs. 87.7%, p<0.001). The latency period was longer when PPROM occurred before 30 weeks of gestation than after 30 weeks of gestation in both groups (median [range]; singleton, 11.5 [0-50] days vs. 3.0 [0-33] days, p<0.001; twin, 3.0 [0-25] days vs. 0 [0-6] day, p<0.001). Although gestational age at delivery was similar in singleton and twin groups, more twin infants had low birth weight, low Apgar score and neonatal morbidities. CONCLUSION: Twin pregnancy with PPROM, compared to singleton pregnancy with PPROM, had shorter latency period and worse perinatal outcome.

Effect of latency period and direction of distraction on the new bone formation during distraction osteogenesis