Pregnancy, puerperium and perinatal constipation - an observational hybrid survey on pregnant and postpartum women and their age-matched non-pregnant controls.

OBJECTIVE: To evaluate the prevalence of constipation during pregnancy and early puerperium. DESIGN: Observational survey. SETTING: Secondary and tertiary hospital in Finland. POPULATION: Pregnant (n = 474) and postpartum (n = 403) women and a control group of 200 non-pregnant women who did not give birth in the past year. METHODS: Women reported bowel function and other gastrointestinal symptoms on a structured questionnaire using an 11-point numerical rating scale (0 = no symptom, 10 = most severe symptom) and binominal yes/no questions during the second and third trimesters and few days and 1 month after childbirth. MAIN OUTCOME MEASURE: Prevalence of constipation based on the Rome IV criteria. RESULTS: The data consist of five cohorts of women: second trimester (n = 264), third trimester (n = 210), after vaginal delivery (n = 200) or caesarean section (n = 203), and a control group (n = 200). The prevalence of constipation was 40% in pregnant women and 52% (P < 0.001) in postpartum women, which was a higher prevalence than that in the control group, where 21% had constipation (P < 0.001). A few days after delivery, the prevalence of constipation was lower after vaginal delivery (47%) than caesarean section (57%, P < 0.039). One month postpartum, the prevalence of constipation was low: 9% after vaginal delivery (P = 0.002 compared with the control group) and 15% after caesarean section. Other gastrointestinal symptoms were common; pregnant women had the highest prevalence (34%) of nausea/vomiting. CONCLUSION: The prevalence of constipation was two- to three-fold higher in pregnant women and a few days after delivery than in non-pregnant women. During puerperium, bowel function returned to or below that reported in non-pregnant women. TWEETABLE ABSTRACT: Constipation is common in pregnancy and after delivery, but bowel function returns early in puerperium.

Galactolipid deficiency in the early pathogenesis of neuronal ceroid lipofuscinosis model Cln8mnd : implications to delayed myelination and oligodendrocyte maturation.

AIMS: CLN8 deficiency underlies one of a group of devastating childhood neurodegenerative disorders, the neuronal ceroid lipofuscinoses. The function of the CLN8 protein is currently unknown, but a role in lipid metabolism has been proposed. In human CLN8 diseased brains, alterations in lipid composition have been detected. To further investigate the connection of CLN8 to lipid metabolism, we characterized the lipid composition of early symptomatic Cln8-deficient mouse (Cln8(mnd)) brains. METHODS: For lipid profiling, Cln8(mnd) cerebral cortical tissue was analysed by liquid chromatography/mass spectrometry. Galactolipid synthesis was measured through enzyme activity and real-time mRNA expression analyses. Based on the findings, myelination and white matter integrity were studied by immunohistochemistry, stereological methods, electron microscopy and magnetic resonance imaging. The development of myelin-forming oligodendrocytes was also studied in vitro. RESULTS: Sphingolipid profiling showed a selective reduction in myelin-enriched galactolipids. The mRNA expression and activity of UDP-galactose:ceramide galactosyltransferase (CGT), the key enzyme in the galactolipid synthesis, was reduced in the Cln8(mnd) brain. Expression of oligodendrocyte markers suggests a maturation defect. The amount of myelin was reduced in 1-month-old Cln8(mnd) mice, but reached normal levels by 5 months of age. The level of Cln8 gene expression followed the developmental pattern of myelin formation and was high in primary oligodendrocytes. CONCLUSIONS: Taken together, these observations suggest that galactolipid deficiency and delayed myelin maturation characterize the early CLN8 disease pathogenesis through a maturation defect of oligodendrocytes.

Developing nurses' capabilities to deputize for ward sisters.

In recent years there has been heated debate on how the training of ward sisters should be conducted in Finland. This is important as in the coming years a large proportion of nurses will be approaching retirement while dramatic changes in mental health organizations during the last two decades have also challenged the role of the ward sister. This paper describes an ongoing project to develop the managerial skills of those nurses working as deputy ward sisters. The project began with a survey of managerial skills, an evaluation of training needs and the necessity for administrative counselling of a group of deputy ward sisters. On the basis of the analysis, a training programme was planned integrating managerial training and administrative counselling in a systematically advancing process.

Serum lipoprotein levels in genetically hypercholesterolaemic RICO rats: effects of a high-sucrose-cholesterol diet without or with altered magnesium and fluoride content.

Genetically hypercholesterolaemic RICO rats (male, 6 weeks old) were randomly distributed into 6 experimental groups. The zero-time basal group A was sacrificed at the start of the experiment while the other groups were fed for 6 weeks and then sacrificed. Group B was fed a stock diet. Control group C was fed a high-sucrose (45%) diet with 0.5% added cholesterol. In the diet of group D, only the magnesium (Mg) content was reduced from the level of group C (883 ppm) to 200 ppm. The diet of group E was the same as that of group D with the addition of 12 ppm of fluoride (F) and the diet of group G was the same as that of group E, but with its Mg content elevated from 200 ppm to 300 ppm. Analysis of aortic blood samples, taken before sacrifice, indicated significant increases in total serum cholesterol (p < 0.01), very low density lipoprotein (VLDL) (p < 0.001) and low density lipoprotein (LDL), (p < 0.001) cholesterol, and a trend to lower high density lipoprotein (HDL) cholesterol in group C, as compared to group B. Significantly lower total (p < 0.05), VLDL (p < 0.01) and LDL (p < 0.01) triglycerides were observed in group C when compared to group B. The LDL phospholipids were significantly higher in group C (p < 0.001) than in group B. When cholesterol levels in groups D, E and G were compared with group C, the VLDL cholesterol in group E and the LDL cholesterol in group G were slightly but significantly (p < 0.05) reduced, while total cholesterol and the other subfractions were unaltered. The LDL triglycerides of groups E and G were significantly smaller still than the already small fraction in group C. The VLDL triglyceride in group E was significantly lower than that of group C (35% reduction, p < 0.001), D and G (p < 0.05). Phospholipids were slightly but significantly reduced in the VLDL fraction of group E and in the LDL fraction of group G (p < 0.05 and 0.01, respectively), as compared to those of group C.