Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study.

OBJECTIVE: To evaluate the impact on cesarean section (CS) rate with of a program of multiple non-clinical interventions targeted at health-care professional within a hospital maternity ward. MATERIALS AND METHODS: Retrospective quasi-experimental pre-post intervention study with an historical control group conducted in a second-level teaching hospital. All women who gave birth in the period 2014 to 2018 were included. A series of multiple non-clinical interventions including a dedicated team of obstetricians for delivery room and antenatal counseling, monthly internal audits and physician education by local opinion leader were prospectively introduced from September 2016. The primary outcome of the study was the CS rate. The incidences of operative vaginal delivery, 3rd-/4th-degree perineal tears and further maternal and neonatal complications were considered as secondary outcomes. RESULTS: The CS rate dropped from 33.05 to 26.06% after starting the interventions (p < 0.01); in particular, the cumulative rate of CS performed during labor decreased significantly from 19.46 to 14.11% (p < 0.01). CS reduction was still statistically significant after multivariate correction (OR = 0.66, CI.95 = 0.57-0.76, p < 0.01). Results further showed an increased prevalence of 3rd-degree perineal tears (0.97% versus 2.24%, p < 0.01), present also after correcting for possible confounding factors (OR = 2.36, CI.95 = 1.48-3.76, p < 0.01). No differences were found in the rate of vaginal-operative births and further maternal complications, while the composite neonatal outcome was found to be improved (OR = 0.73, CI.95 = 0.57-0.93, p = 0.010). CONCLUSIONS: The introduction of multiple non-clinical interventions can significantly reduce the CS rate. However, beside an improvement in neonatal composite outcome, a potential increase in high-degree perineal tears should be taken in account.

Symptoms after sport-related concussions alter gestural functions.

OBJECTIVES: Symptoms after sport-related concussions (SRC) are common. Because post-concussion symptoms are often not clearly visible, speech-accompanying gestures may help clinicians to gain additional information about the patient's history and symptoms during medical consultation. We hypothesized that athletes with SRC and who suffered from persisting symptoms would display more gestures during concussion assessment protocols when compared to non-concussed athletes because of the athletes' previous motor-sensory experiences made during the concussive event. DESIGN: A retrospective cross-sectional study. METHODS: Three matched groups of 40 (active) athletes were investigated in the context of concussion assessment (/and baseline) protocols: 14 symptomatic and 14 asymptomatic athletes with a SRC, and 12 non-concussed athletes. Certified raters using a standard analysis system for nonverbal behaviour analysed videotaped hand movements and gestures during a standardized concussion assessment protocol. RESULTS: Symptomatic athletes spent significantly more time with in space hand movements, i.e., movements that act in the body-external free space without touching anything and specifically, motion quality presentation gestures than non-concussed athletes. CONCLUSIONS: Increased in space movements, which are functionally gestures, and specifically, motion quality presentation gestures in symptomatic athletes indicate that the more vivid sensory motor experience of the head trauma is reflected in more gestural expressions. Thus, hand movements and gestures differentiate athletes who suffer from post-concussion symptoms from non-concussed athletes indicating the athletes' motor-sensory experiences of the event and its aftereffects. The present study highlights the fact that gestures can be employed as behavioural markers of symptoms after sport-related concussions.

Changed cortical activity after anterior cruciate ligament reconstruction in a joint position paradigm: an EEG study.

After reconstruction of the anterior cruciate ligament (ACL) afferent proprioceptive information from the knee joint may be altered. In order to examine changes in central activation patterns, spectral features of the electroencephalography (EEG) were measured. Patients after ACL reconstruction and healthy controls carried out an knee-angle reproduction task in a groups x limbs x trials design. Cortical activity was recorded using international standards. FFT were conducted to determine power at Theta, Alpha-1, Alpha-2 and Beta-1. Statistics show significantly larger aberrations in the reconstructed limbs compared with the controls whereas there are no differences between the uninvolved land controls. Brain activity demonstrates significantly higher frontal Theta-power (F3, F4, F8) in both limbs of the ACL group vs the controls and a significantly higher Alpha-2 power was shown in the ACL-reconstructed limb compared with controls at parietal positions (P3, P4). No such differences were found between the uninvolved side and the controls. The EEG was able to measure a change in joint position sense at the cortical level after the reconstruction of the ACL. The results of these findings might indicate differences in focused attention with involvement of the anterior cingulate cortex (frontal Theta) and sensory processing in the parietal somatosensory cortex (Alpha-2).

Taxonomical classification of the guinea pig based on its Cu/Zn superoxide dismutase sequence.

Cu-Zn superoxide dismutase was purified from guinea pig (Cavia porcellus) liver up to electrophoretic homogeneity and its amino acid sequence was elucidated by automated Edman degradation of proteolytic fragments and mass spectrometry. The protein was classified as a typical mammalian cytosolic Cu-Zn superoxide dismutase by molecular mass, specific activity, amino acid sequence and N-terminal acetylation. A dendrogram constructed from previously known vertebrate cytosolic Cu-Zn superoxide dismutase sequences reflects the commonly accepted taxonomy and phylogenetic relationships of the species, whereas the guinea pig sequence is similarly remote form muriform rodents, lagomorphs, equiforms and primates. The data appear incompatible with the assumption that the Caviomorpha with the representative Cavia porcellus form a common phylogenetic clade with the muriform rodents but rather have to be considered a distinct order of mammals. The degree of similarity of the sequences further suggests that the mammalian clade diverged into rodents, primates, lagomorphs and caviomorphs at about the same time.

Highly fluorochrome labeled gene probes for quantitative tracing of RNA in individual cells by in situ hybridization.

A new method is presented for preparing highly fluorochrome labeled gene probes suitable for in situ hybridization. For this purpose fluorochromes were attached to a synthetic polypeptide, which was then coupled covalently to various gene probes. The advantage of the reported method is its high labeling efficiency and the easy coupling procedure. The method allows rapid and quantitative detection of homologous RNA at the single cell level. Optimal conditions for the hybridization of fluorochrome-labeled gene probes were established microfluorimetrically, and the specificity and sensitivity of the method were tested. Quantitation of the RNA with a fluorochrome-labeled gene probe in situ in individual cells allows determination of the degree of gene activation in individual cells and may thus provide a new tool for investigation of normal and malignant cells with respect to activation of genes controlling differentiation and proliferation.

Quantitative tracing of mRNAs for T- and B-lymphocyte receptor genes in individual cells by in situ hybridization with fluorochrome-labeled gene probes. I. Expression in malignancies carrying B-lineage associated antigens.

Acute and chronic lymphatic leukemias were investigated on the single-cell level for the activity of genes coding for the IgM heavy chain and the alpha and beta chains of the T-cell antigen receptor (TCR). We used a new method for preparing highly fluorochrome-labeled gene probes for in situ hybridization, which allowed rapid and quantitative detection of mRNA at the individual cell level. Leukemic cell populations classified as belonging to the B lineage according to their surface antigenic patterns revealed increasing expression of mRNA for the IgM heavy chain (mu mRNA) in a maturation-dependent fashion, which was not correlated to rearrangement of the immunoglobulin mu chain gene--only 66% of the leukemias with rearranged mu gene also transcribed it. TCR mRNA was detected in B-antigen positive leukemic cells. High levels of both TCR and mu mRNA expression in all cells of some of these leukemias allowed the conclusion that these cells simultaneously transcribed the genes for T and B cell antigen receptors. TCR mRNA was also found in what are considered relatively mature B leukemias, lineage cross-over on the mRNA level being observed at a frequency of 23% (five of 22 cases), comparable with that of "inappropriate" receptor gene rearrangement. The quantitation of mRNA with fluorochrome-labeled gene probes in situ may allow determining the degree of gene activation in individual antigenically defined cells and may thus contribute a new tool for characterization of normal and malignant cells.

The amino-acid sequence of rabbit Cu-Zn superoxide dismutase.

The primary structure of Cu-Zn superoxide dismutase from rabbit liver was investigated. The reduced and S-carboxymethylated enzyme was treated with cyanogen bromide, trypsin or Staphylococcus aureus proteinase V8. The resulting peptides were separated by high-performance liquid chromatography and sequenced by automated Edman degradation. With the exception of the N- and C-terminus the complete sequence was established by means of overlapping peptides. The N-terminus is blocked and thus not susceptible to Edman degradation. The amino-acid composition of the tryptic N-terminal peptide corresponds to that of the cytoplasmatic Cu-Zn superoxide dismutases of other mammals investigated. The chromatographic behaviour of these N-terminal peptides on a reversed phase C18 column is also identical, thus suggesting also for the rabbit Cu-Zn superoxide dismutase the N-terminal sequence Ac-Ala-Thr-Lys. The C-terminus was demonstrated to have the sequence -Ile-Ala-Pro by enzymatic degradation with carboxypeptidase Y. The complete amino-acid sequence of the rabbit Cu-Zn superoxide dismutase consists of 152 amino-acids and shows the expected homology to other Cu-Zn enzymes published so far. The aspartate and six histidine residues known to complex the metal ions are conserved at homologous positions. This also applies for the arginine residue near the C-terminus which is supposed to direct the anionic superoxide radical towards the active centre of the enzyme. The amino acid sequence of the rabbit Cu-Zn superoxide dismutase corresponds to those of other mammals in more than 80% of its amino-acid residues. From a total of 152 amino-acid residues the rabbit shares with rat 128, with mouse 130, with horse 127, with pig 126/127, with cattle 130 and with man 131 amino acids in homologous positions. However the Cu-Zn superoxide dismutases of closely related mammals like rats and mice differ in only five amino acid residues of their sequence. A phylogenetic closer relatedness between lagomorphs and rodents than between other orders of mammals, could not be derived from the sequence data given. Rather rodents and lagomorphs are to be considered as two evolutionary independent orders of mammals.

Determinacion de actividad de acetilcolinesterasa (ACE) mediante biopsia rectal por succion. / Determination of the activity of acetylcholinesterase (ACE) by means of aspiration rectal biopsy

Se realizan 34 BRS para estudio histoquimico de ACE, en ninos portadores de enfermedad de Hirschsprung, operados y constipados rebeldes a tratamiento medico. Se describe la tecnica utilizada e los resultados obtenidos. Se concluye que es un metodo simple, rapido y util para diagnosticar aganglionosis intestinal congenita

Correlacion manometrica, histologica e histoquimica en el estudio de megacolon en el nino. / Manometric, histological and histochemical correlation in the study of megacolon in children

Se practicaron 96 manometrias anorrectales en ninos con megacolon. En dieciseis los registros eran compatibles con enfermedad de Hirschsprung:en 12 la biopsia rectal por succion para determinar acetilcolinesterasa corroboro el diagnostico de aganglionosis. En 2 pacientes con manometrias no concluyentes, la actividad acetilcolinesterasica resulto altamente positiva,y en uno de ellos se obtuvo el diagnostico de displasia neuronal colonica mediante el estudio de la deshidrogenasa succinica

Absence of fractionation, protraction, radiation quality, and radical scavenger effects on radiation-induced interphase death of human G0 lymphocytes in vitro.

In vitro interphase death of human peripheral blood lymphocytes, measured by shortening of the mean lifetime of small G0 lymphocytes, was studied with 150 kV and 10 kV X-rays. No effect of radiation quality, of fractionation and of protraction was observed. The possibility of protection by L-cysteine and DMSO was tested in cells irradiated with 150 kV X-rays, but no protection effect with respect to cell survival could be demonstrated. Non-DNA radiation-sensitive site(s), possibly the cell membrane, appear to be responsible for interphase death.

[The journal "Stomatologiia" (Moskva)--The professional organ of the Medico-Scientific Allunion Society of Stomatologists of the Soviet Union]. / Die Zeitschrift "Stomatologija" (Moskva) - das Fachorgan der Medizinisch-Wissenschaftlichen Allunionsgesellschaft der Stomatologen der Sowjetunion.

The present synopsis IV (1974) concludes the commentation of the major papers of Soviet authors which have appeared in the 1974 volume of the Stomatologija (Moskva). It considers publications on documentation and diagnosis, the use of metals in the oral cavity, anatomical-topographic-histologic problems, selected topics of basic research, pain perception and conduction and nerval problems as well, and papers from the whole field of orthopaedic stomatology (prosthodontics) and on work organization and problems of accounting, the care of working teams and problems of occupational hygiene.

[The journal "Stomatologija" (Moskva)--the organ of the Medico-Scientific Allunion Dental Society of the Soviet Union]. / Die Zeitschrift "Stomatologija" (Moskva)-das Fachorgan der Medizinisch-Wissenschaftlichen Allunionsgesellschaft der Stomatologen der Sowjetunion.

By dealing with papers on problems of anaesthesia and narcosis, the present synopis III (1974) concludes the survey of the complex of surgical stomatology treated in the synopsis II (1974). Furthermore, it is concerned with articles of Soviet authors on affections of the salivary glands, the pathology of the manidublar joint and of rheumatoid diseases, certain diseases of the oral mucous membranes, and with papers from the whole field of paedodontics including orthodontics.

[The journal "Stomatologija (Moskva)"--organ of the medico-scientific all-union Society of Stomatologists of the Soviet Union. Synopsis II]. / Die Zeitschrift "Stomatologija" (Moskva)--das Fachorgan der Medizinisch-Wissenschaftlichen Allunionsgesellschaft der Stomatologen der Sowjetunion Ubersichtsreferat II (1974).

The present synopsis of the contents of the 1974 volume of the "Stomatologija (Moskva)" treats exclusively problems of surgical stomatology. It considers papers on maxillofacial traumatopathies, fracture surgery, transplantation of teeth and tooth germs, inflammatory diseases, certain surgical-stomatological diseases and neoplasms, bone grafting, extraction surgery and related surgical interventions, and treatment of congenital defects in the maxillofacial region. The synopsis III (1974) (to be published in the next number of the Stomatologie der DDR) will report on further branches of surgical stomatology.