Plasma corticosterone response to chronic ethanol consumption and exercise stress.

Acute exposure to ethanol induces a stress response in mice that is manifested by increased plasma corticosterone (PC) concentration. However, during chronic intake of 7.5% w/v ethanol, diurnal fluctuation of PC is dampened. Whether chronic consumption of 20% w/v ethanol alters normal diurnal fluctuation of plasma glucocorticoids is not known. Investigating the PC response in 20% w/v ethanol-consuming mice is of interest because glucocorticoids are known suppressants of natural killer (NK) cell activity and increased concentration or altered diurnal fluctuation of PC may have a modulatory role on NK cells in these mice. Mice given 20% w/v ethanol for at least 7 days and for as long as 10 weeks have suppressed splenic NK cell cytolytic activity. Thus, the purpose of this study was to examine whether mice given 20% w/v ethanol exhibited normal concentrations and diurnal variation of PC. To further define the glucocorticoid response in chronic ethanol-consuming mice, PC concentration was evaluated in response to a secondary stress of physical exercise. After 1 week, ethanol-consuming mice exhibited abnormal diurnal PC periodicity that was progressively dampened during the remaining 9 weeks. Acute physical exercise during Week 1 induced a 2-fold increase in PC concentration compared with pre-exercise values, a response that was independent of ethanol intake. After 6 and 10 weeks, the postexercise PC concentration was attenuated in ethanol-consuming compared with water-drinking mice. It was concluded that suppressed NK cell activity typically observed with this model of chronic ethanol intake is not directly associated with dampened diurnal fluctuation in PC.

Maternal transport of patients with advanced cervical dilatation--to fly or not to fly?

Emergency maternal transport of women in advanced preterm labor often involves difficult decisions about whether to transport or not. A retrospective review of maternal transports performed in northern Arizona by Samaritan Air Evac covered a 21-month period. Of the 1080 patients transported for preterm labor, 54 calls for transport (5%) were received when the patient was 7 cm or more dilated. Five women were delivered at the referring hospital and 49 were transported, none of whom delivered en route. Only 21 (39%) of them delivered in the first hour after arrival at the tertiary center. The decision to transport patients in advanced preterm labor should be based on such factors as distance between hospitals, time required to cover that distance, personnel on the transport, facilities available at the transporting hospital, gestational age, and speed with which labor has progressed.