Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011.

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes. This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011. Data were collected on all women admitted to the delivery ward during February to May 2011 (the months of the most active fighting in the city) (n = 7096), and October to December 2010 (the months immediately before the war) (n = 5935). Compared with the preceding months there was a significant rise during the conflict in the rate of deliveries involving preterm (3.6% versus 2.5%) and low-birth-weight (10.1% versus 8.5%) infants and caesarean sections (26.9% versus 25.3%). Psychosocial stress may have been a factor (among others) in an increase in negative pregnancy outcomes, and obstetric hospitals should be aware of these issues in times of war.

Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes.This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011.Data were collected on all women admitted to the delivery ward during February to May 2011 [the months of the most active fighting in the city][n - 7096], and October to December 2010 (the months immediately before the war][n = 5935]. Compared with the preceding months there was a significant rise during the conflict in the rate of deliveries involving preterm [3.6% versus 2.5%]and low-birth-weight [10, 1% versus 8.5%]infants and caesarean sections [26.9% versus 25.3%]. Psychosocial stress may have been a factor [among others]in an increase in negative pregnancy outcomes, and obstetric hospitals should be aware of these issues in times of war

قد تؤدي أحداث الحياة الضاغطة التي تعاني منها الحوامل إلى حصائل توليدية ضائرة. وتقدم هذه الدراسة التي أجريت في بنغازي مقارنة لمعدلات الولادة قبل الأوان، والوزن المنخفض أثناء الولادة، والولادات القيصرية في مستشفى الجماهيرية قبل وخلال الشهور التي سبقت النزاع المسلح في ليبيا عام 2011 . وقد جمع الباحثون البيانات عن جميع الحوامل اللاتي أدخلن إلى جناح الولادة خلال الأشهر من شباط/فبراير إلى أيار/مايو 2011 ، وهي الشهور التي اندلع فيها القتال الأكثر ضراوة في المدينة، وعددهن 7096 حاملا، واللاتي أدخلن خلال الأشهر من تشرين الأول/أكتوبر إلى كانون الأول/ديسمبر 2010 ، وهي الأشهر التي سبقت القتال مباشرة، وعددهن 5935 حاملا. وبالمقارنة مع الأشهر السابقة اتضح وجود ارتفاع يعتد به إحصائيا في معدلات الولادة قبل الأوان [3.6 % مقابل 2.5 %]، ونقص الوزن عند الولادة [10.1 % مقابل 8.5 %]، والعمليات القيصرية [26.9 % مقابل 25.3 %]. إن الكرب النفسي قد يكون واحد من العوامل المتعددة التي تزيد من الحصائل السلبية للحمل، وينبغي أن تتنبه مستشفيات التوليد لهذه القضايا في أوقات الحروب

Les femmes enceintes qui vivent des événements stressants peuvent être plus à risque d'une issue obstétricale défavorable.L'étude menée à Benghazi a comparé les taux de prématurité, de faible poids de naissance et de césarienne à l'hôpital Al-Jamhouria dans les mois précédant et pendant le conflit armé en Libye en 2011.Les données recueillies auprès de toutes les femmes admises en salle d'accouchement entre février et mai 2011 [au plus fort des combats dans la ville][n = 7096], et entre octobre et décembre 2010 [les mois précédant la guerre][n = 5935]. Par rapport aux mois précédents, une augmentation importante du taux d'accouchements impliquant une prématurité [3, 6 % contre 2, 5 %]et un faible poids de naissance [10, 1 % contre 8, 5 %]ainsi que des césariennes [26, 9 % contre 25, 3 %]a été observée pendant le conflit.Le stress psychosocial peut avoir été un facteur [entre autres]dans l'augmentation des issues négatives de la grossesse, et les établissements obstétricaux devraient être informés de ces problèmes en temps de guerre

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life.

PURPOSE: This systematic review aimed to assess the literature for prevalence, severity, and impact on quality of life of salivary gland hypofunction and xerostomia induced by cancer therapies. METHODS: The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. Two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results and conclusions for each article. RESULTS: The inclusion criteria were met by 184 articles covering salivary gland hypofunction and xerostomia induced by conventional, 3D conformal radiotherapy or intensity-modulated radiotherapy in head and neck cancer patients, cancer chemotherapy, total body irradiation/hematopoietic stem cell transplantation, radioactive iodine treatment, and immunotherapy. CONCLUSIONS: Salivary gland hypofunction and xerostomia are induced by radiotherapy in the head and neck region depending on the cumulative radiation dose to the gland tissue. Treatment focus should be on optimized/new approaches to further reduce the dose to the parotids, and particularly submandibular and minor salivary glands, as these glands are major contributors to moistening of oral tissues. Other cancer treatments also induce salivary gland hypofunction, although to a lesser severity, and in the case of chemotherapy and immunotherapy, the adverse effect is temporary. Fields of sparse literature included pediatric cancer populations, cancer chemotherapy, radioactive iodine treatment, total body irradiation/hematopoietic stem cell transplantation, and immunotherapy.

A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact.

PURPOSE: This systematic review aimed to assess the literature for management strategies and economic impact of salivary gland hypofunction and xerostomia induced by cancer therapies and to determine the quality of evidence-based management recommendations. METHODS: The electronic databases of MEDLINE/PubMed and EMBASE were searched for articles published in English since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies until 2008 inclusive. For each article, two independent reviewers extracted information regarding study design, study population, interventions, outcome measures, results, and conclusions. RESULTS: Seventy-two interventional studies met the inclusion criteria. In addition, 49 intensity-modulated radiation therapy (IMRT) studies were included as a management strategy aiming for less salivary gland damage. Management guideline recommendations were drawn up for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. CONCLUSIONS: There is evidence that salivary gland hypofunction and xerostomia induced by cancer therapies can be prevented or symptoms be minimized to some degree, depending on the type of cancer treatment. Management guideline recommendations are provided for IMRT, amifostine, muscarinic agonist stimulation, oral mucosal lubricants, acupuncture, and submandibular gland transfer. Fields of sparse literature identified included effects of gustatory and masticatory stimulation, specific oral mucosal lubricant formulas, submandibular gland transfer, acupuncture, hyperbaric oxygen treatment, management strategies in pediatric cancer populations, and the economic consequences of salivary gland hypofunction and xerostomia.

Pain perception during transrectal ultrasound guided prostate needle biopsy: an objective analysis of local anesthesia use.

We assessed the effect of periprostatic nerve blockade during transrectal ultrasound of the prostate prior to obtaining systematic needle biopsies and the discomfort associated with this procedure. A prospective randomized study was performed on 100 men requiring systematic needle biopsy of the prostate. Patients were assigned to two groups: Group 1 received no local anesthesia and Group 2 received a periprostatic injection of 5 ml 1% lidocaine solution (2.5 ml bilaterally) prior to undergoing biopsy of the prostate. The patients were asked to respond to a pre- and post-procedural questionnaire which consisted of four questions designed to evaluate pain perception and pain experienced, respectively, during the entire procedure. Mean pain scores for Group 1 responses vs Group 2 responses were not statistically different for any of the pre-procedural questions. Post-procedural pain scores were significantly lower in Group 2 vs Group 1 (control) for questions 1 and 3: question 1 (2.6+/-1.8 vs 3.8+/-1.8, P<0.05), question 2 (3.0+/-1.9 vs 3.7+/-2.1, P=0.14). Question 3 (2.8+/-2.0 vs 4.3+/-1.9, P<0.05), and question 4 (1.6+/-2.4 vs 2.1+/-2.6, P=0.38). During the study, no patient from Group 2 experienced any adverse reaction from the injection. Our data suggest that periprostatic nerve blockade during transrectal ultrasound of the prostate results in less patient discomfort.

Abundant Pathogenic Variation in the New Hybrid Rust Melampsora xcolumbiana on Hybrid Poplar.

ABSTRACT The recently described rust hybrid Melampsora xcolumbiana was discovered as a result of its novel pathogenic variation on Populus trichocarpa x P. deltoides (TxD) hybrid poplar. To characterize this pathogenic variation, 10 commercial TxD clones, all F(1) clones, were chosen as host differentials. Fourteen mononuredinial isolates of Pacific Northwestern field collections of M. xcolumbiana, from 1996 to 1998 inclusive, were determined to be 13 distinct pathotypes. In contrast, four Southeastern isolates of M. medusae could not be distinguished on the same TxD host differentials, although they can be distinguished as pathotypes using P. deltoides differentials. The first three pathotypes of M. xcolumbiana (Mxc1, Mxc2, and Mxc3) and a Mississippi isolate of M. medusae were inoculated onto a three-generation TxD pedigree, formerly used to characterize the Mmd1 gene for resistance to M. medusae. Resistance to the Mxc3 pathotype mapped to the same linkage group (group Q) as the Mmd1 gene. In contrast, linked genes for resistance to Mxc1 and to Mxc2 were located on linkage group O, and were unlike Mmd1 and Mxc3 in that they were inherited from P. deltoides. The latter two genes resembled Mmd1 and Mxc3 in that infection type was correlated with quantitative traits such as uredinial density and latent period. Pathogenic variation in M. xcolumbiana matches resistance genes from both P. trichocarpa and P. deltoides and reveals the vulnerability to hybrid rust of commercial TxD hybrid poplar clones.

A second-generation screen of the human genome for susceptibility to insulin-dependent diabetes mellitus.

During the past decade, the genetics of type 1 (insulin-dependent) diabetes mellitus (IDDM) has been studied extensively and the disorder has become a paradigm for genetically complex diseases. Previous genome screens and studies focused on candidate genes have provided evidence for genetic linkage between polymorphic DNA markers and 15 putative IDDM susceptibility loci, designated IDDM1-IDDM15. We have carried out a second-generation screen of the genome for linkage and analysed the data by multipoint linkage methods. An initial panel of 212 affected sibpairs (ASPs) was genotyped for 438 markers spanning all autosomes, and an additional 467 ASPs were used for follow-up genotyping. Other than the well-established linkage with the HLA region at chromosome 6p21.3, there was only one region, located on chromosome 1q and not previously reported, where the log likelihood ratio (lod) was greater than 3. Lods between 1.0 and 1.8 were found in six other regions, three of which have been reported in other studies. Another reported region, on chromosome 6q and loosely linked to HLA, also had an elevated lod. Little or no support was found for most reported IDDM loci (lods were less than 1), despite larger sample sizes in the present study.

A genome-wide search for human non-insulin-dependent (type 2) diabetes genes reveals a major susceptibility locus on chromosome 2.

Non-insulin-dependent (type 2) diabetes mellitus (NIDDM) is a common disorder of middle-aged individuals characterized by high blood glucose levels which, if untreated, can cause serious medical complications and lead to early death. Genetic factors play an important role in determining susceptibility to this disorder. However, the number of genes involved, their chromosomal location and the magnitude of their effect on NIDDM susceptibility are unknown. We have screened the human genome for susceptibility genes for NIDDM using non-and quasi-parametric linkage analysis methods in a group of Mexican American affected sib pairs. One marker, D2S125, showed significant evidence of linkage to NIDDM and appears to be a major factor affecting the development of diabetes mellitus in Mexican Americans. We propose that this locus be designated NIDDM1.

Linkage studies in NIDDM with markers near the sulphonylurea receptor gene.

The high affinity receptor for sulphonylureas, expressed on the beta cells of the pancreas, plays a crucial role in the control of insulin secretion. Mutations in the cytoplasmic domain of the sulphonylurea receptor (SUR) gene that disrupt the regulation of insulin secretion have been previously described. In the present study, the potential role of genetic variation in the SUR gene has been investigated in non-insulin-dependent diabetes mellitus (NIDDM) through linkage studies with microsatellite markers tightly linked to the SUR gene. The microsatellite markers were typed in 346 Mexican-American NIDDM affected sib pairs derived from 176 families and an additional 110 ethnically and geographically matched control subjects. No evidence of linkage, based on allele sharing, or association based on allele frequencies in patients and control subjects, for any microsatellite marker and NIDDM was observed in this population. These results suggest that genetic variation in the SUR gene does not play a major role in susceptibility to NIDDM in the Mexican-American population.

Identification of microsatellite markers near the human ob gene and linkage studies in NIDDM-affected sib pairs.

Non-insulin-dependent diabetes mellitus (NIDDM) is a complex metabolic disorder with a significant genetic component. Obesity is a frequent complicating factor for NIDDM. In the mouse, a number of single gene defects that result in obesity have been described. Mutations in one of these genes, the ob gene, results in both obesity and NIDDM. Recently, the cloning of the murine ob gene and its human homologue has been reported (Nature 372:425-432, 1994). In the present study, the contribution of genetic variation at the human ob locus to NIDDM susceptibility was assessed by analyzing allele sharing in NIDDM-affected sib pairs (ASPs) for markers located near the human ob gene. Four yeast artificial chromosome clones containing the human ob gene were isolated. These clones colocalized the ob gene and two microsatellite markers, D7S514 and D7S635, to a region of 280 kb on the long arm of human chromosome 7. The microsatellite markers were typed in 346 Mexican-American NIDDM-ASPs derived from 176 families and an additional 110 ethnically and geographically matched controls. No evidence of linkage or association between either microsatellite marker and NIDDM was observed in this population. These results suggest genetic variation in the human ob gene does not play a major role in susceptibility to NIDDM in Mexican-Americans.

Protection from the embryopathic effects of 7-hydroxymethyl-12-methylbenz(a)anthracene by 2-methyl-1,2-bis-(3-pyridyl)1-propanone(metopirone, Ciba) and beta-diethylaminoethyldiphenyl-n-propyl acetate (SKF 525-A).

Pretreatment with Metopirone (40 mg.) or SKF 525-A (2 mg./100 g. maternal body weight) protected aganist the embryotoxic and teratogenic actions of7-OHM-12-MBA) (2.5 mg/100 g. maternal body weight) in the Sprague-Dawley rat. At the doses administered SKF-525-A was a more efficient protector than Metopirone. The adrenocorticolytic actions of 7-OHM-12-MBA in the maternal adrenal glands were also prevented by these compounds and a close correlation existed between the degree of protection of the maternal adrenals and of the foetuses. It is suggested that the ultimate embryopathic substance is a metabolite of 7-OHM-12-MBA.