Valproic acid selectively increases vascular endothelial tissue-type plasminogen activator production and reduces thrombus formation in the mouse.

Essentials Stimulating endogenous fibrinolysis could be a novel antithrombotic strategy. The effect of valproic acid on endothelial tissue plasminogen activator in mice was investigated. Valproic acid increased tissue plasminogen activator expression in vascular endothelium. Valproic acid reduced fibrin deposition and thrombus formation after vascular injury. SUMMARY: Background The endogenous fibrinolytic system has rarely been considered as a target to prevent thrombotic disease. Tissue-type plasminogen activator (t-PA) production is potently increased by histone deacetylase (HDAC) inhibitors in endothelial cells in vitro, but whether this translates into increased vascular t-PA production and an enhanced fibrinolytic capacity in vivo is unknown. Objectives To determine whether the HDAC inhibitor valproic acid (VPA) stimulates production of t-PA in the vasculature of mice, and whether VPA pretreatment affects fibrin deposition and clot formation after mechanical vessel injury. Methods Mice were injected with VPA twice daily for up to 5 days. t-PA mRNA, and antigen expression in the mouse aorta and the circulating levels of t-PA were determined. Fibrin and thrombus dynamics after mechanical vessel injury were monitored with intravital confocal microscopy. Potential effects of VPA on platelets and coagulation were investigated. Results and Conclusions We found that VPA treatment increased vascular t-PA production in vivo and, importantly, that VPA administration was associated with reduced fibrin accumulation and smaller thrombi in response to vascular injury, but still was not associated with an increased risk of bleeding. Furthermore, we observed that higher concentrations of VPA were required to stimulate t-PA production in the brain than in the vasculature. Thus, this study shows that VPA can be dosed to selectively manipulate the fibrinolytic system in the vascular compartment and reduce thrombus formation in vivo.

Evaluation of gait impairment in mice subjected to craniotomy and traumatic brain injury.

Traumatic brain injury (TBI) represents a significant global health burden and causes long-lasting neuromotor deficits, particularly in individuals who sustain severe TBI. A better understanding of gait impairment after experimental TBI will provide valuable information for the recovery and rehabilitation of TBI survivors. Here we utilised the DigiGait system to perform kinematic gait analysis in mice subjected to brain injury induced by the controlled cortical impact (CCI) TBI model. Naïve mice, non-craniotomised and craniotomised mice were included as controls. The temporal and spatial profile of gait was mapped from 3h to 1-week post-TBI. Remarkably, there was a noticeable alteration in some aspects of gait in craniotomised sham mice from their pre-surgery baseline at various time-points over the testing period. This was not observed in naïve mice or non-craniotomised sham controls over the same time period. This finding indicates that the craniotomy procedure alone effects gait. When craniotomised mice were subjected to TBI, additional deleterious effects on gait function were observed, including forelimb stance and swing duration as well as left hindlimb swing and stride duration and frequency. Hence, mice subjected to CCI-induced TBI develop clear alterations in gait but part of this is attributable to the effect of craniotomy alone. This study also highlights the need to include both non-craniotomised and craniotomised sham mice as controls when undertaking the CCI-induced model of TBI, particularly when early time points are being evaluated.

Do maternity hospital practices support Greek mothers' decision to breastfeed?

AIM: Previous studies have shown that the conditions in Greek maternity hospitals do not support the right of mothers and their children to breastfeed. The aim of the present report was to investigate the degree that Greek maternity hospitals have adopted the 'Ten Steps to Successful Breastfeeding'. METHODS: The study sample comprised 140 mothers living in Athens who had recently given birth and volunteered to fill in specific questionnaires. RESULTS: 40.5% of the mothers did not know what the first meal of their baby was. Regarding hospitals' practices, 68.3% of the mothers mentioned that artificial milk was brought in every meal of the neonate, while 63.6% believed that artificial milk was given to their child without their knowledge, despite the fact that they had already decided to breastfeed. Ninety percent of the mothers giving birth in public maternity hospitals and 60% delivering in private clinics mentioned that health professionals supported breastfeeding (p < 0.05). CONCLUSIONS: It seems that in daily practice, Greece has not yet created an appropriate well informed and supportive environment in regard to breastfeeding.

Abuse assessment screen (AAS) questionnaire: the Greek validation.

AIM: Domestic violence is a social problem with increasing dimensions worldwide. The various forms of abuse and especially violence during pregnancy have not been sufficiently studied by the Greek scientific community. The aim of this study was to translate, culturally adapt and validate a special research tool that can be used by health professionals as a diagnostic tool for violence during pregnancy. METHODS: The Abuse Assessment Screen (AAS) questionnaire was chosen as a screening tool. The questionnaire was translated into Greek in accordance with the procedure suggested by the 'Trust Scientific Advisory Committee', followed by the cultural adaptation of the questionnaire to the Greek reality. RESULTS: Specific psychometric tests were used for the validation of the questionnaire in order to assess the questionnaire's reliability and validity, and a factor analysis was also carried out. The internal consistency for all the parties who were questioned (n = 262), as expressed by Cronbach's alpha coefficient for the AAS, was 0.806 which is quite satisfactory and the results of our study suggest that the Greek translation of the AAS has a high correlation index compared to relevant international studies. CONCLUSIONS: The AAS questionnaire in the Greek version seems to be a reliable and valid tool for the diagnosis of violence during pregnancy.

Factors associated with initiation and duration of breastfeeding in Greece.

AIM: Our aim was to study factors affecting the initiation, progress and duration of breastfeeding in Greece. METHODS: We studied 938 infants born in 2001 in 17 maternity hospitals in Greece. RESULTS: The percentage of breastfeeding infants was 85.5%. The actual progress of breastfeeding was different from the one that the mothers intended to follow. Although the majority of women claimed in the beginning that they would breastfeed mainly for four to six months (23.2%) and 12-14 months (23.1%), the majority had discontinued breastfeeding by the fourth month (58.5%) and only 7.3% breastfed for more than one year. The initiation time of breastfeeding was positively influenced by natural delivery (p = 0) and pleasant delivery (p = 0.397). Smoking was negatively associated with the duration of breastfeeding (p = 0) and the infants of smokers breastfed mainly for one to two months (38.7%). Exclusive breastfeeding in the maternity hospital was positively associated with the mother's intention to refuse to use a mixed diet after being discharged (p = 0). CONCLUSION: Greater support is needed so that women can implement their original intentions concerning the progress of breastfeeding.

Factors influencing the initiation and progress of breastfeeding in Greece.

OBJECTIVE: The aim of this study was to investigate and assess the factors associated with the initiation, progress, and duration of breastfeeding in Greece. METHODS: We studied 1,010 infants born from 862 women from 1996 to 2000 in 17 hospitals. We followed the mothers for the period January-October 2001, while they were at the maternity hospitals to give birth to their next child. RESULTS: Statistical analysis of the data showed that factors positively associated with the duration of breast-feeding were the application of rooming-in (p = 0.0001), the initiation time of breast-feeding--mainly one to six hours after delivery (p = 0.0004), natural delivery (p = 0), pleasant delivery (p = 0.0142), the time the decision about breastfeeding was taken (p = 0), the fact that it was mainly a maternal decision and the mothers were not influenced by a specific person (p = 0.0272) and the fact that no mixed diet was administered (p = 0). Smoking was negatively associated with the duration of breastfeeding (p = 0.0036). Factors not associated with the duration of breastfeeding were: number of the mother's family members (p = 0.1231), whether the women themselves were breastfed as babies (p = 0.03924), some elements of their personality (p = 0.3871) as well as their beliefs concerning maternal milk (p = 0.1922). CONCLUSIONS: From our results we have indications as to which factors are related or unrelated to the initiation and progress of breastfeeding in Greece.