[Obstetric prevention of neonatal infections caused by group B beta-hemolytic Streptococcus]. / La profilassi ostetrica delle infezioni neonatali da streptococco beta-emolitico di gruppo B.

While our understanding of Group B Streptococcal infections has progressed with impressive measure, their prevention has not been accompanied by an effective means. Chemoprophylaxis for selected colonized women at rupture of membranes or at onset of labour, enhances benefit and minimizes adverse effects. Two or more maternal risk factors are special circumstances for routine use of chemoprophylaxis in asymptomatic neonates. Immunoprophylaxis by IgG antibodies directed against the type-specific polysaccharide antigen of GBS may be provided by passive or active immunization. Hyperimmune i.v. globulins or vaccination of adult women with low levels of antibodies in their sera have been demonstrate to be protective in vivo.

Adenosine triphosphate release by osmotic shock and hemoglobin A1C in diabetic subjects' erythrocytes.

We investigated the significance of adenosine triphosphate (ATP) release from diabetic subjects' red blood cells (RBCs) following osmotic shock (OS) and its possible relationship with hemoglobin A1C (HbA1C) and with the RBC membrane protein skeleton. RBCs from type I (insulin-dependent [IDDM]) and type II (non-insulin-dependent [NIDDM]) diabetic subjects and age- and sex-matched control subjects were submitted to OS using NaCl solutions (from 0.9% to 0.045% final concentration). ATP release values were determined by the bioluminescent method. For pattern study, they were expressed both as absolute values and as percentages (%) of ATP maximum release (at 0.045% NaCl solution). Twenty-seven IDDM and 25 NIDDM subjects and two control groups were investigated. ATP content in RBCs was 2.08 +/- 0.19 pmol/10(4) RBC in IDDM and 1.23 +/- 0.20 pmol/10(4) RBC in NIDDM subjects. The ATP content of IDDM subjects' RBCs was significantly higher than that of the corresponding control group. ATP release at 0.49% NaCI OS, both as absolute value and as percentage value, was significantly lower in both diabetic groups, and ATP% was inversely correlated with HbA1" (IDDM: r = -.489, P < .01; NIDDM: r = -.654, P < .01), suggesting a possible relationship between Hb glycation, RBC membrane protein skeleton glycation, and its influence on ATP release by OS. In conclusion, the proposed method seems useful for measuring RBC ATP content and, at the same time, for monitoring the leak effect of the RBC membrane before it bursts.

[Malaria and pregnancy. Theoretical premises and practical behavior]. / Malaria e gravidanza. Premesse teoriche e comportamento pratico.

Although knowledge of mutual relations between malaria and pregnancy remain incomplete, malaria is a very real risk for both mothers and foetuses in tropical country obstetrics. On the basis of personal experience in Somalia, some theoretical premises are reported on relations between malaria and pregnancy and a consolidated therapeutic protocol is illustrated.

[Obstetrics in Somalia. Maternal and infant mortality in the metropolitan area of Mogadishu. The current situation and future prospects]. / Ostetricia in Somalia. La mortalità materna e infantile nell'area metropolitana di Mogadiscio. Situazione attuale e prospettive future.

Maternal and infant mortality in Somalia are very high: the obstetric situation of the country in relation to socioeconomic conditions is presented. The factors responsible for this tragic situation are outlined critically and, finally, the essential points of a pilot project aimed at lowering maternal mortality for obstetric causes from current levels (1,100/100,000 live births) which cannot be accepted even in a developing country, are summarised.

[Elephantiasis of the vulva and the legs. Medical and surgical treatment of a case of lymphatic filariasis]. / Elefantiasi vulvare e degli arti inferiori. Terapia medica e chirurgica di un caso di filariosi linfatica.

After reviewing the main causes of elephantiasis in tropical countries, the results of combined medical and surgical treatment of a case of lymphatic filariasis are reported. Medical treatment consists of a cycle of high-dose mebendazole (40 mg/kg/die) and subsequent cycles of diethylcarbamazine at a habitual dose (6 mg/kg/die). In the interval, the elephantiasic right lip was removed surgically. The overall clinical results was good. Noteworthy was an unwanted, leukopenising side-effect of high-dose mebendazole.

[Gynecologic and obstetric implications of female circumcision in Somalia]. / Implicazioni ginecologiche e ostetriche della circoncisione femminile in Somalia.

Some historical and cultural notes on the traditional practice of female circumcision are presented, the various forms and features of the population of Somaliland being described. The complications of circumcision are illustrated, particularly its most mutilating form (infibulation) which can present to the observation of the gynaecologist, together with a summary description of some clinical cases. Finally, mention is made of the current and future outlook for the spread of this traditional mutilating practice.

Birth rate and perinatal mortality in Italy during the years 1964 through 1986.

"Between 1964 and 1986 the number of births in Italy declined from over one million per year to little more than half a million per year. The perinatal mortality rate declined from 37.3/1,000 to 12.8/1,000. Using the year 1964 as [the] reference year, the total number of babies who were saved from perinatal death by socio-economic and medical improvements during the 22 years between 1965 and 1986 can be calculated as 435,005."

Nuclear aberrations and micronuclei induction in the digestive tract of mice treated with different iron salts.

Toxic effects of ferrous sulfate and of ferric chloride were determined in the gastrointestinal tract by measuring the induction of nuclear aberrations and micronuclei. In fasting animals ferric chloride induced a dose-related increase of nuclear aberrations in the stomach, whereas ferrous sulfate was not active. In normally feeding animals no increase of nuclear aberrations was observed. The effects of the iron compounds on the duodenum were minimal. In fasting animals a dose-related increase of nuclear aberrations was observed at the level of the colon, with no clear difference between ferrous and ferric compounds. A modest increase of nuclear aberrations of the colon was seen in feeding animals only with ferrous sulphate. By intrarectal administration, nuclear aberrations were induced especially by ferric chloride. An increase of the frequency of micronuclei was not observed at the level of the stomach, duodenum and colon, with the exception of ferric chloride, that induces a significant, although small increase of colon micronuclei when administered intra-rectally. The data demonstrate that iron compounds have an intrinsic cellular toxicity when not administered with food, but do not seem to carry any genotoxic potential for the gastrointestinal tract.

Nuclear damage of colon epithelial cells by the food carcinogen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) is modulated by dietary lipids.

Intestinal damage in C57BL/6J female mice was quantified by measuring the frequency of nuclear aberrations in colonic crypts. The animals were maintained on the following diets: standard (5% lipids, 5% cellulose); low- and high-cellulose (0-20% cellulose); high lipids (20% maize oil or 20% olive oil). All groups of animals were treated by gavage either with saline or 250 mg/kg of the dietary carcinogen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ). After 24 h their colons were removed and stained and the nuclear aberrations scored under the microscope. The administration of IQ markedly increased the number of colon aberrations in all of the treated animals. Variations in dietary fiber did not modify the colon-damaging activity of this compound. Maize oil slightly increased the colon-damaging activity, whereas significant protection was observed in the animals on a high-lipid olive-oil diet. These results show that composition of the diet may vary the genotoxic effect of this dietary carcinogen.

Score systems in perinatal medicine.

Details of some common scoring systems in use for perinatal medicine are outlined. Their advantages and limitations are briefly discussed.

Enzymic assay of creatinine in serum and urine with creatinine iminohydrolase and glutamate dehydrogenase.

We describe an assay for creatinine in which it is converted by creatinine iminohydrolase (EC 3.5.4.21) into ammonia and N-methylhydantoin. The ammonia is subsequently assayed by use of alpha-ketoglutarate and glutamate dehydrogenase (EC 1.4.1.3). Use of NADPH as coenzyme eliminates all interferences from endogenous reactions. Endogenous ammonia in the sample is eliminated during a preincubation. The reaction reaches the endpoint in 15 min at working temperatures of 20-37 degrees C. No sample blank or reagent blank is needed. The standard curve is linear at least to 884 mumol (100 mg) of creatinine per liter. Average analytical recovery of creatinine in serum and urine is 99%. Within-run and between-run CVs are less than or equal to 2% and less than or equal to 6% for creatinine values of 335 mumol/L (38 mg/L) and 80 mumol/L (0 mg/L), respectively. Results by the described method (y) compare well with those by Jaffé's kinetic test (y = 1.01x -- 12.8), Berthelot/AutoAnalyzer method after treatment with immobilized creatinine iminohydrolase (y = 0.987x -- 13.2), Jaffé's test run on the SMA 12/60 (y = 1.011x -- 5.8), the Wahlefeld method (y = 1.014x -- 0.88), and Jaffé's test after deproteinization and absorption on fuller's earth (y = 0.985x -- 3.08). The method may be suitable for discrete, including centrifugal, automation.

[Menarche in healthy and sick girls with special reference to mongolism]. / Menarche gesunder und kranker Mädchen.

The age of menarche in various groups of females was studied. In healthy girls, the average age of menarche was 12 years 2 months regardless of their birthweights. Twin girls had a significantly retarded menarche (approx. 12 years 8 months). In a group of 102 blind patients, it was not significantly different from healthy controls. In a series of 42 girls with mongolism, the mean age of menarche was significantly retarded (13 years 3 months).