Biomarkers of abnormally invasive placenta.

INTRODUCTION: Abnormally invasive placenta (AIP, aka placenta accreta spectrum; PAS) is an increasingly common pregnancy pathology, which, despite significant morbidity risk to the mother, is often undiagnosed prior to delivery. We tested several potential biomarkers in plasma from PAS mothers to determine whether any were sufficiently robust for a formal, diagnostic accuracy study. METHODS: We examined hyperglycosylated hCG (h-hCG), decorin and IL-8, based on biological plausibility and literature indications that they might be altered in PAS. These analytes were assayed by ELISA in maternal plasma from five groups, comprising (1) normal term controls, (2) placenta previa controls, and cases of (3) placenta increta/percreta without placenta previa, (4) placenta previa increta/percreta and (5) placenta previa accreta. RESULTS: There were no differences in h-hCG, ß-hCG or the h-hCG/ß-hCG ratio between the groups. Mean decorin levels were increased in previa controls (Group 2) compared to the other groups, but there was substantial overlap between the individual values. While an initial multiplex assay showed a greater value for IL-8 in the placenta previa increta/percreta group (Group 4) compared to placenta previa controls (Group 2), the subsequent validation ELISA for IL-8 showed no differences between the groups. DISCUSSION: We conclude that the absence of differences and the extent of overlap between cases and controls does not justify further assessment of these biomarkers.

Las demandas por conducta suicida a los servicios de urgencias prehospitalarios de Málaga: características y factores asociados / Calls due to suicidal behaviour made to the prehospital, emergency department in Málaga: characteristics and associated factors

Fundamento: El comportamiento suicida, mortal y no mortal, se ha convertido en un problema grave de salud pública en muchos países. El objetivo de este estudio es describir las características diferenciales de las llamadas al Centro Coordinador de Urgencias y Emergencias de la provincia de Málaga por conducta suicida, frente a las llamadas por problemas físicos o psiquiátricos. Material y métodos: Esta investigación consiste en un estudio observacional retrospectivo de las demandas registradas en la base de datos de la Empresa Pública de Emergencias Sanitarias durante un año. Las comparaciones y análisis de regresión logística multivariante se realizaron respecto a la edad y sexo de los demandantes y respecto a las siguientes características de las demandas: horas del día, días laborables o festivos, meses del año y trimestres, número de recursos movilizados y tipos de resolución. Resultados: Los análisis se realizaron sobre un total de 163.331 llamadas. 1.380 fueron por conducta suicida (0,8%), 9.951 por motivos psiquiátricos (6,1%) y 152.000 por motivos físicos (93%). Las llamadas por conducta suicida fueron realizadas preferentemente por mujeres jóvenes, que solicitan atención durante la tarde y la noche, requiriendo traslado al hospital y la movilización de más de un recurso sanitario. Las demandas por suicidio consumado las realizaron más frecuentemente varones en edades más avanzadas. En el primer trimestre del año se dan más demandas por ideación que por amenaza/intento, mientras que en el tercer trimestre ocurre lo contrario. Conclusión: Los resultados indicaron características diferenciales de las llamadas por conducta suicida potencialmente relevantes para la prevención del suicidio (AU)

Background: Suicidal behaviour (fatal and non-fatal) has become a serious public health problem in many countries. The aim of the study was to describe the differential characteristics of emergency calls due to suicidal behaviour made to the Emergency Coordinating Centre (CCUE) in the province of Málaga, in comparison with calls due to physical or psychiatric problems. Methods: Retrospective observational study of the calls recorded in the database of the Public Company for Emergency Health during one year. Multivariate logistic regression analyses were carried out including age, gender and the following variables related with the demand: hours of the day, type of day (working days or bank holidays), months of the year and trimesters, number of resources mobilized and types of resolution. Results: The analyses were carried out on 163,331 calls, of which 1,380 calls were due to suicidal behaviour (0.8%), 9,951 for psychiatric reasons (6.1%) and 152,000 for physical reasons (93%). The emergency calls for suicidal behaviour were mainly made by females, between 31-60 years, in the evening and at night, and required transfer to hospital and more than one mobilized resource. Calls due to completed suicide were more frequently made by older men. Calls due to suicidal tendencies predominated over those due to attempted or threatened suicide during the first trimester of the year, while the opposite was the case during the third trimester. Conclusions: The results indicated differential characteristics of suicide calls that are potentially relevant for prevention in spite of the limitations of the present study (AU)

[Calls due to suicidal behaviour made to the prehospital, emergency department in Málaga: characteristics and associated factors]. / Las demandas por conducta suicida a los servicios de urgencias prehospitalarios de Málaga: características y factores asociados.

BACKGROUND: Suicidal behaviour (fatal and non-fatal) has become a serious public health problem in many countries. The aim of the study was to describe the differential characteristics of emergency calls due to suicidal behaviour made to the Emergency Coordinating Centre (CCUE) in the province of Málaga, in comparison with calls due to physical or psychiatric problems. METHODS: Retrospective observational study of the calls recorded in the database of the Public Company for Emergency Health during one year. Multivariate logistic regression analyses were carried out including age, gender and the following variables related with the demand: hours of the day, type of day (working days or bank holidays), months of the year and trimesters, number of resources mobilized and types of resolution. RESULTS: The analyses were carried out on 163,331 calls, of which 1,380 calls were due to suicidal behaviour (0.8%), 9,951 for psychiatric reasons (6.1%) and 152,000 for physical reasons (93%). The emergency calls for suicidal behaviour were mainly made by females, between 31-60 years, in the evening and at night, and required transfer to hospital and more than one mobilized resource. Calls due to completed suicide were more frequently made by older men. Calls due to suicidal tendencies predominated over those due to attempted or threatened suicide during the first trimester of the year, while the opposite was the case during the third trimester. CONCLUSIONS: The results indicated differential characteristics of suicide calls that are potentially relevant for prevention in spite of the limitations of the present study.

Desarrollo y validación de un método multiresiduo para el análisis de plaguicidas en miel por UFLC-MS / Development and validation of a multiresidue method for pesticide analysis in honey by UFLC-MS / Desenvolvimento e validação de um método de resíduos múltiplos para o analise de agrotóxicos em mel por UFLC-MS

Resumen Se desarrolló un método para la determinación de residuos de plaguicidas en miel de abejas mediante cromatografía líquida ultra rápida acoplada a espectrometría de masas(cuádruplo sencillo). Se partió del método QuEChERS, evaluando las siguientes variables: (i) cantidad de muestra, (ii) tipo de sal para el control de pH, (iii) valor de pH del buffer y (iv) mezclas de limpieza. Adicionalmente y con el propósito de demostrar la confiabilidad del método, se evaluaron diferentes parámetros como exactitud, límites de detección y cuantificación, linealidad y selectividad. Los resultados mostraron que, mediante las modificaciones realizadas, se logró obtener un método más selectivo y se mejoró la exactitud de 19 plaguicidas respecto al método QuEChERS original. Por otro lado, mediante el proceso de validación, se encontró que el método es apto para el análisis de 50 plaguicidas (de 56 que se emplearon). Se obtuvieron porcentajes de recuperación entre el 70 y 120% y coeficientes de variación inferiores al 15%

Abstract A method for the determination of pesticide residues in honey by ultra fast liquid chromatography coupled with mass spectrometry was developed. For this purpose, different variations of the QuECHERS method were performed: (i) amount of sample, (ii) type of salt to control pH, (iii) buffer pH, and (iv) different mixtures for cleaning-up. In addition, to demonstrate that the method is reliable, different validation parameters were studied: accuracy, limits of detection and quantification, linearity, and selectivity. The results showed that by means of the changes introduced it was possible to get a more selective method that improves the accuracy of about 19 pesticides selected from the original method. It was found that the method is suitable for the analysis of 50 pesticides, out of 56. Furthermore, with the developed method recoveries between 70 and 120% and relative standard deviation below 15% were found.

Resumo Foi desenvolvido um método para a determinação de resíduos de pesticidas no mel por cromatografia líquida ultrarrápida acoplada à espectrometría de massa. Para este efeito, foram realizadas diferentes variações do método QuEChERS: (i) quantidade de amostra, (ii) tipo de sal para o controle do pH, (iii) valor do pH do tampão, (iv) diferentes misturas de limpeza. Além disso, a fim de demonstrar que o método é confiável, diferentes parâmetros foram validados como: precisão, limite de detecção e quantificação, linearidade e seletividade. Os resultados mostraram que, por meio das modificações é possível obter um método mais seletivo que melhora a precisão de cerca de 19 pesticidas selecionados, respeito ao método original. Adicionalmente, foi determinado que a validação do método estabeleceu que este é adequado para a análise de 50 pesticidas (56 foram utilizados). Foram obtidos percentagens de recuperação entre 70 e 120% e coeficientes de variação menores ao 15%.

Comparación de dos métodos para el análisis multiresiduo de plaguicidas en polen / Comparsion of two multiresidue methods for pesticide determination in pollen / Comparação de duas metodologias para o analise de residuos múltiplos de agrotóxicos em pólen

Se realizó un estudio comparativo entre el método QuEChERS convencional para la determinación de residuos de plaguicidas en polen y un método modificado, con el propósito de seleccionar el método que funciona adecuadamente. Para ello, se analizaron 58 plaguicidas mediante el uso de cromatografía líquida acoplada a espectrometría de masas; la comparación de los métodos se realizó utilizando diferentes parámetros de validación como: recuperación, precisión (como repetibilidad) y límites de detección, los cuales fueron estimados mediante diferentes aproximaciones. Sumado a esto, se realizó un diseño experimental factorial que permitió evaluar la eficiencia de ambos métodos en diferentes tipos de polen. Los resultados indicaron, que el método desarrollado es apto para el análisis de residuos de plaguicidas en polen. Asimismo, se encontró que el método desarrollado presenta mejores límites de detección, mejor exactitud y mejor selectividad que el método QuEChERS convencional para el análisis de los plaguicidas en estudio en la matriz de polen apícola. Finalmente, se encontró que el método modificado no es apto para el análisis de tres de los 58 plaguicidas estudiados.

A comparative study between the conventional and the modified QuEChERS method was performed in order to select the methodology that works better for the determination of pesticide residues in pollen. For this study, 58 pesticides were analyzed by liquid chromatography coupled to mass spectrometry. Comparison was made using different validation parameters for each method as recovery, precision (as repeatability), limits of detection, which were estimate using different approaches. In addition, a factorial design was used to evaluate the efficiency of both methods in different types of pollen. The results showed that the modified method is appropriate for the analysis of pesticide residues in pollen. It was also found that this method has better detection limits, better accuracy and better selectivity than the conventional QuEChERS method for pesticide analysis in bee pollen. Finally, it was found that the modified method is not suitable for the analysis of three of the 58 pesticides studied.

Com o objetivo de validar o bom funcionamento de uma análise modificada de resíduos de pesticidas no pólen foi realizado um estudo comparativo com o método QuEChERS. Por isso, 58 pesticidas foram analisados usando espectrometria de massa por cromatograf ia líquida; comparação dos métodos foi realizada utilizando diferentes parâmetros de validação, como a recuperação de precisão (como repetibilidade) e limites de detecção que foram estimadas por diferentes abordagens. Somado a isso, um planejamento fatorial permitiu avaliar a eficiência de ambos métodos em diferentes tipos de pólen. Os resultados indicaram que o método desenvolvido é adequado para a análise de resíduos de pesticidas no pólen. Constatou-se também que o método desenvolvido tem melhores limites de detecção, melhor precisão e maior seletividade do que o método QuEChERS para análise de pesticidas no estudo da matriz de pólen de abelha. Finalmente, verificou-se que o método modificado não é adequado para a análise de 3 dos 58 pesticidas, os quais apresentaram recuperações inferiores ao 70%.

Cesarean scar pregnancy is a precursor of morbidly adherent placenta.

OBJECTIVE: To provide further sonographic, clinical and histological evidence that Cesarean scar pregnancy (CSP) is a precursor to and an early form of second- and third-trimester morbidly adherent placenta (MAP). METHODS: This is a report of 10 cases of CSP identified early, in which the patients decided to continue the pregnancy, following counseling that emphasized the possibility of both significant pregnancy complications and a need for hysterectomy. Pregnancies were followed at 2-4-week intervals with ultrasound scans and customary monitoring. The aim was for patients to reach near term or term and then undergo elective Cesarean delivery and, if necessary, hysterectomy. Charts, ultrasound images, operative reports and histopathological examinations of the placentae were reviewed. RESULTS: The ultrasound diagnosis of CSP was made before 10 weeks. By the second trimester, all patients exhibited sonographic signs of MAP. Nine of the 10 patients delivered liveborn neonates between 32 and 37 weeks. In the tenth pregnancy, progressive shortening of the cervix and intractable vaginal bleeding prompted termination, with hysterectomy, at 20 weeks. Two other patients in the cohort had antepartum complications (bleeding at 33 weeks in one case and contractions at 32 weeks in the other). All patients underwent hysterectomy at the time of Cesarean delivery, with total blood loss ranging from 300 to 6000 mL. Placenta percreta was the histopathological diagnosis in all 10 cases. CONCLUSION: The cases in this series validate the hypothesis that CSP is a precursor of MAP, both sharing the same histopathology. Our findings provide evidence that can be used to counsel patients with CSP, to enable them to make an informed choice between first-trimester termination and continuation of the pregnancy, with its risk of premature delivery and loss of uterus and fertility.

IFPA Meeting 2013 Workshop Report II: use of 'omics' in understanding placental development, bioinformatics tools for gene expression analysis, planning and coordination of a placenta research network, placental imaging, evolutionary approaches to understanding pre-eclampsia.

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At the IFPA meeting 2013 twelve themed workshops were presented, five of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of new technologies for placenta research: 1) use of 'omics' in understanding placental development and pathologies; 2) bioinformatics and use of omics technologies; 3) planning and coordination of a placenta research network; 4) clinical imaging and pathological outcomes; 5) placental evolution.

Evidence for extraplacental sources of circulating angiogenic growth effectors in human pregnancy.

Pregnancy complications such as preeclampsia (PE) and intrauterine growth restriction (IUGR) are associated with reduced blood flow, contributing to placental and fetal hypoxia. Placental hypoxia is thought to cause altered production of angiogenic growth effectors (AGEs), reflected in the circulation of mother and fetus. Vascular endothelial growth factor (VEGF), placental growth factor (PlGF) and their soluble binding protein (sFlt-1) are, in turn, postulated as being causally involved in PE via induction of systemic endothelial cell dysfunction. To dissect the role of AGEs, accurate measurement is of great importance. However, the values of AGEs are highly variable, contributing to heterogeneity in their association (or lack thereof) with preeclampsia. To test the hypothesis that variability may be due to peripheral cell release of AGEs we obtained blood samples from normal healthy pregnant women (n = 90) and the cord blood of a subset of their neonates using standard serum separation and compared results obtained in parallel samples collected into reagents designed to inhibit peripheral cell activation (sodium citrate, theophylline, adenosine and dipyridamole-CTAD). AGEs were measured by ELISA. CTAD collection reduced maternal and fetal free VEGF by 83%, and 98%, respectively. Free PlGF was decreased by 29%, maternal sFlt-1 by >20% and fetal sFlt-1 by 59% in the CTAD-treated vs. serum sample (p < 0.0001). In summary blood collection techniques can profoundly alter measured concentrations of AGEs in mother and fetus. This process is highly variable, contributes to variation reported in the literature, and renders questionable the true impact of alteration in AGEs on pregnancy pathologies.

Comparación de iiferentes aproximaciones para etimar límites de detección en aanálisis de residuos de plaguicidas en alimentos / Comparison of different approache to estimate limits of detection for pesticide residues analysis in food / Comparaão de differentes abordagens par estimar os limites de detecçãoo na análise de resíduos de pesticidas em alimentos

El cálculo de los límites de detección (LD) es una práctica que ha generado diversas discusiones en la comunidad científica, debido a las diferentes definiciones y los procedimientos para realizar su estimación. En este estudio se aplicaron, confirmaron y compararon seis de los métodos más empleados en la estimación de LD en el análisis de residuos de plaguicidas. Los métodos evaluados correspondieron a IUPAC (por sus siglas en ingles, International Union of Pure and Applied Chemistry), la EPA (por sus siglas en ingles, Enviroment Protection Agency), t99, raíz media cuadrática del error (RMSE), Hubaux-Vos y propagación de errores. Este estudio se realizó sobre cinco productos vegetales empleando el método QuEChERS en la determinación de 31 plaguicidas, y el análisis de las muestras se realizó mediante cromatografía líquida acoplada a espectrometría de masas. Los resultados mostraron que los LD estimados con los diferentes métodos no presentaron una variación significativa con la matriz de análisis, exceptuando el método de la EPA. Por su parte, en la comprobación de los LD se encontró que los métodos t99, RMSE y Hubaux-Vos mostraron la menor relación señal ruido (S/R<3), mientras que los métodos de IUPAC y propagación de errores presentaron las mejores relaciones S/R. Finalmente, ningún método estimó los LD para todos los compuestos con relaciones S/R adecuadas.

The limit of detection (LOD) calculation is a practice that has generated several discussions in the scientific community, due to different definitions and procedures for its estimation. The fundamental objective of the present work is to apply, confirm and compare six different recommendations suggested by official guidelines for the estimation of LOD of 31 pesticide residues in five different commodities using the QuEChERS method and ultra fast liquid chromatography coupled to mass spectrometry. The methods evaluated were IUPAC, EPA, t99, root mean square error (RMSE), Hubaux- Vos and propagation of errors. In this study it was found that limits of detection of the different approaches did not show a significant variation with the commodities tested, excluding the method of EPA. On the other hand, t99, RMSE and Hubaux methods showed the lowest signal to noise ratio (S/N<3). Furthermore, the EPA approach showed the highest S/N, while IUPAC and propagation of errors methods presented the best S/N. Finally, no method estimated the limits of detection for all compounds with ratios S /N appropriate.

O cálculo dos limites de detecção (LD) é uma prática que tem levado a várias discussões na comunidade científica, devido a diferentes definições e procedimentos para a sua estimativa. Este estudo aplicou, confirmando e comparados seis dos métodos utilizados na estimativa de LD na análise de resíduos de pesticidas. Os métodos avaliados foram para IUPAC, EPA, t99, erro médio quadrático (RMSE), Hubaux-Vos e propagação de erros. Este estudo foi realizado em cinco produtos de plantas utilizando o método de determinação de pesticidas QuEChERS 31, a análise das amostras foi realizada por espectrometria de massa de cromatografia líquida. Os resultados mostraram que o LD estimada com diferentes métodos não houve variação significativa com a matriz de análise, a não ser o método EPA. Enquanto isso, no controlo da LD-se que os métodos de t99, RMSE e Hubaux-Vos apresentaram menor relação sinal-ruído (S / N <3), enquanto os métodos de propagação de erro da IUPAC e teve as melhores relações S / R Finalmente, o LD qualquer método considerado para todos os compostos, com relações S / R adequados.

Global protein synthesis in human trophoblast is resistant to inhibition by hypoxia.

Placental growth and function depend on syncytial cell processes which require the continuing synthesis of cellular proteins. The substantial energy demands of protein synthesis are met primarily from oxidative metabolism. Although the responses of individual proteins produced by the syncytiotrophoblast to oxygen deprivation have been investigated previously, there is no information available on global protein synthesis in syncytiotrophoblast under conditions of hypoxia. These studies were designed to test the hypothesis that syncytial protein synthesis is decreased in a dose-dependent manner by hypoxia. Experiments were performed to measure amino acid incorporation into proteins in primary syncytiotrophoblast cells exposed to oxygen concentrations ranging from 0 to 10%. Compared to cells exposed to normoxia (10% O2), no changes were observed following exposure to 5% or 3% O2, but after exposure to 1% O2, protein synthesis after 24 and 48 h decreased by 24% and 23% and with exposure to 0% O2, by 65% and 50%. As a consequence of these results, we hypothesized that global protein synthesis in conditions of severe hypoxia was being supported by glucose metabolism. Additional experiments were performed therefore to examine the role of glucose in supporting protein synthesis. These demonstrated that at each oxygen concentration there was a significant, decreasing linear trend in protein synthesis as glucose concentration was reduced. Under conditions of near-anoxia and in the absence of glucose, protein synthesis was reduced by >85%. Even under normoxic conditions (defined as 10% O2) and in the presence of oxidative substrates, reductions in glucose were accompanied by decreases in protein synthesis. These experiments demonstrate that syncytiotrophoblast cells are resistant to reductions in protein synthesis at O2 concentrations greater than 1%. This could be explained by our finding that a significant fraction of protein synthesis in the syncytiotrophoblast is sustained by glycolytic metabolism. This suggests that with increasing degrees of chronic hypoxia there is a shift from oxidative to glycolytic pathways, allowing a substantial degree of protein synthesis to be maintained.

Glucose transporter 3 (GLUT3) protein expression in human placenta across gestation.

Conflicting information regarding expression of GLUT3 protein in the human placenta has been reported and the localization and pattern of expression of GLUT3 protein across gestation has not been clearly defined. The objective of this study was characterization of syncytial GLUT3 protein expression across gestation. We hypothesized that GLUT3 protein is present in the syncytial microvillous membrane and that its expression decreases over gestation. GLUT3 protein was measured in samples from a range of gestational ages (first to third trimester), with human brain and human bowel used as a positive and negative control respectively. As an additional measure of specificity, we transfected BeWo choriocarcinoma cells, a trophoblast cell line expressing GLUT3, with siRNA directed against GLUT3 and analyzed expression by Western blotting. GLUT3 was detected in the syncytiotrophoblast at all gestational ages by immunohistochemistry. Using Western blotting GLUT3 was detected as an integral membrane protein at a molecular weight of ∼50 kDa in microvillous membranes from all trimesters but not in syncytial basal membranes. The identity of the primary antibody target was confirmed by demonstrating that expression of the immunoblotting signal in GLUT3 siRNA-treated BeWo was decreased to 18 ± 6% (mean ± SEM) of that seen in cells transfected with a non-targeting siRNA. GLUT3 expression in microvillous membranes detected by Western blot decreased through the trimesters such that expression in the second trimester (wks 14-26) was 48 ± 7% of that in the first trimester and by the third trimester (wks 31-40) only 34 ± 10% of first trimester expression. In addition, glucose uptake into BeWo cells treated with GLUT3 siRNA was reduced to 60% of that measured in cells treated with the non-targeting siRNA. This suggests that GLUT3-mediated uptake comprises approximately 50% of glucose uptake into BeWo cells. These results confirm the hypothesis that GLUT3 is present in the syncytial microvillous membrane early in gestation and decreases thereafter, supporting the idea that GLUT3 is of greater importance for glucose uptake early in gestation.

IFPA Meeting 2010 Workshops Report II: Placental pathology; trophoblast invasion; fetal sex; parasites and the placenta; decidua and embryonic or fetal loss; trophoblast differentiation and syncytialisation.

Workshops are an important part of the IFPA annual meeting. At IFPA Meeting 2010 diverse topics were discussed in twelve themed workshops, six of which are summarized in this report. 1. The placental pathology workshop focused on clinical correlates of placenta accreta/percreta. 2. Mechanisms of regulation of trophoblast invasion and spiral artery remodeling were discussed in the trophoblast invasion workshop. 3. The fetal sex and intrauterine stress workshop explored recent work on placental sex differences and discussed them in the context of whether boys live dangerously in the womb.4. The workshop on parasites addressed inflammatory responses as a sign of interaction between placental tissue and parasites. 5. The decidua and embryonic/fetal loss workshop focused on key regulatory mediators in the decidua, embryo and fetus and how alterations in expression may contribute to different diseases and adverse conditions of pregnancy. 6. The trophoblast differentiation and syncytialisation workshop addressed the regulation of villous cytotrophoblast differentiation and how variations may lead to placental dysfunction and pregnancy complications.

Chronic hypoxia in vivo reduces placental oxidative stress.

Decreased placental oxygenation and increased oxidative stress are implicated in the development of preeclampsia. Oxidative stress arises from imbalance between pro-versus anti-oxidants and can lead to biological oxidation and apoptosis. Because pregnant women living at high altitude (3100 m, HA) have lowered arterial PO2 and an increased incidence of preeclampsia, we hypothesized that HA placentas would have decreased anti-oxidant enzyme activity, increased oxidative stress (lipid peroxidation, protein oxidation and nitration) and greater trophoblast apoptosis than low-altitude (LA) placentas. We measured enzymatic activities, lipid and protein oxidation and co-factor concentrations by spectrophotometric techniques and ELISA in 12 LA and 18 HA placentas. Immunohistochemistry (IHC) was used to evaluate nitrated proteins and specific markers of apoptosis (activated caspase 3 and M30). Superoxide dismutase activity was marginally lower (p=0.05), while glutathione peroxidase activity (p<0.05), thioredoxin concentrations (p<0.005) and thioredoxin reductase activity p<0.01 were all reduced in HA placentas. Decreased anti-oxidant activity was not associated with increased oxidative stress: lipid peroxide content and protein carbonyl formation were lower at HA (p<0.01). We found greater nitrotyrosine residues in the syncytiotrophoblast at 3100 m (p<0.05), but apoptosis did not differ between altitudes. Our data suggest that hypoxia does not increase placental oxidative stress in vivo. Nitrative stress may be a consequence of hypoxia but does not appear to contribute to increased apoptosis. Lowered placental concentrations of anti-oxidants may contribute to the susceptibility of women living at HA to the development of preeclampsia, but are unlikely to be etiological.

Caracterizacióndde ácidos húmicos y fúlvicos de un mollisol bajo dos coberturas difreentes / Charaterization of humic and fulvic acids from a mollisol under two diferent coverlands

Para evaluar y comparar algunas propiedades de los ácidos húmicos (AH) y fúlvicos (AF) como el grado de condensación y polimerización, el contenido total de carbono, hidrógeno y nitrógeno, y sus constantes de acidez, se analizó la fracción menor a 50 µm de un Mollisol del horizonte Ap, bajo caña de azúcar, y se comparó con un horizonte A, bajo bosque. Para tal fin se hicieron extracciones sucesivas con tetraborato de sodio 0,05 M, pirofosfato de sodio 0,025 M e hidróxido de sodio 0,1M. Las sustancias húmicas se purificaron mediante tratamientos con ácidos inorgánicos en solución al 1% de HCl y HF, resinas de absorción Amberlita XAD-16 e intercambio catiónico R101H+, diálisis y liofilización, y se caracterizaron por análisis elemental, relación E4/E6 y potenciometría ácido-base de acuerdo con las funciones de Gran modificadas. La relación E4/E6 permitió establecer mayores tamaños moleculares y grado de condensación de los ácidos húmicos en relación con los ácidos fúlvicos. Por potenciometría ácido-base se determinaron, en los ácidos húmicos y ácidos fúlvicos, las concentraciones de grupos funcionales ácidos y sus respectivas constantes de acidez. Dos de éstas, tituladas entre pH 4,0 y 6,1 corresponden a grupos carboxílicos, las otras dos entre pH 7,2 y 8,7 son el resultado de grupos -OH fenólicos fuertes y carboxílicos débiles. En el horizonte Ap, bajo caña de azúcar, los resultados demostraron que las prácticas de uso y manejo de este cultivo han llevado a la homogeneización de las sustancias húmicas, mientras que en el horizonte A bajo bosque existen ácidos húmicos y fúlvicos diferenciados por tamaño molecular, aromaticidad y grado de humificación.

In order to determine and to compare some physicochemical properties of humic (HA) and fulvic (FA) acids such as degree of condensation and polymerization, the total C,H,N content and pKa values were analyzed in the smaller fraction (< 50 m) from Ap horizon under sugarcane crop in opposition to A horizon under forest, both Mollisol order. To carry out this aim, successive extractions with sodium tetraborate 0.05 M, sodium pyrophosphate 0.025 M, and sodium hydroxide 0.1 M were made. The purification of these humic substances by treatment with inorganic acids 1% solutions of HCl and HF, Amberlite XAD-16 adsorption resin and R 101H+ cationic exchange, dialysis and freeze driying were done. The humic and fulvic acids were characterized by elemental analysis, E4/E6 relation and acid-base potentiometry. The ratio E4/E6 allows to establish that molecular size and degree of condensation in humic acids were bigger than in fulvic acids. By means of acid-base potentiometry, the concentrations of functional acid groups and their acid constants in the humic and fulvic acids were determined. Four constants were found; first and second between pH 4.0 and 6.1 correspond to differents kinds of carboxyl groups and another two between pH 7.2 and 8.7 come from strong O-H phenolic and weak carboxyl groups. In the Ap horizon under sugarcane the characterization showed that the handling and land use practices promote the homogeneity of humic substances meanwhile in the A horizon under forest; the humic and fulvic acids are different due to their degree of condensation molecular size and humification index.

Effects of chronic hypoxia in vivo on the expression of human placental glucose transporters.

Birth weight is reduced and the risk of preeclampsia is increased in human high altitude pregnancies. There has been little work to determine whether hypoxia acts directly to reduce fetal growth (e.g. reduced blood flow and oxygen delivery), or via changes in functional capacities such as nutrient transport. We therefore investigated the expression of a primary nutrient transporter, the GLUT1 glucose transporter and two in vitro markers of hypoxia (erythropoietin receptor, EPO-R, and transferrin receptor, TfR) in the syncytial microvillous (MVM) and basal membrane fractions (BMF) of 13 high (3100 m) and 12 low (1600 m) altitude placentas from normal term pregnancies. Birth weight was lower at 3100 m than at 1600 m despite similar gestational age, but none of the infants were clinically designated as fetal growth restriction. EPO-R, TfR and GLUT1 were examined by immunoblotting and maternal circulating erythropoietin and transferrin by ELISA. EPO-R was greater on the MVM (+75%) and BMF (+25%) at 3100 m. TfR was 32% lower on the MVM at 3100 m. GLUT1 was 40% lower in the BMF at 3100 m. Circulating EPO was greater at high altitude, while transferrin was similar, and neither correlated with their membrane receptors. BMF GLUT1 was positively correlated with birth weight at high, but not low altitude. In this in vivo model of chronic placental hypoxia, syncytial EPO-R increased as expected, while nutrient transporters decreased, opposite to what has been observed in vitro. Therefore, hypoxia acts to reduce fetal growth not simply by reducing oxygen delivery, but also by decreasing the density of nutrient transporters.

Remodelling of uteroplacental arteries is decreased in high altitude placentae.

Uterine blood flow and birth weight are reduced and the risk of pre-eclampsia is increased in high-altitude pregnancies. Since IUGR and pre-eclampsia are associated with reduced invasion and remodelling of maternal spiral arteries we asked whether the terminal ends of uteroplacental arteries located at the maternal-foetal decidual interface evidenced less remodelling in 19 high (3100 m) compared with 13 moderate (1600 m) altitude placentae from normal pregnancies. Previous work has demonstrated marked villous angiogenesis in high altitude placentae. We asked whether such changes are compensatory for reduced modelling and/or whether they contribute to increased birth weight. Placentae were randomly sampled and examined with immunohistochemistry to evaluate vessel remodelling and foetal capillary density. The decidual ends of uteroplacental arteries were 8-fold more likely to be remodelled at 1600 vs. 3100 m (OR=8.1; CI 2.4, 27.0,P< 0.001). There were more than twice as many uteroplacental arteries observed in the high vs. moderate altitude placentae (OR=2.1; CI: 1.3, 3.5, P=0.006). Foetal capillary density was greater at 3100 vs. 1600 m (P< 0.001), but did not relate to remodelling nor to birth weight. In this in vivo model for chronic hypoxia, remodelling is reduced, and villous angiogenesis is not fully compensatory for reduced PO(2).

The differential effect of haloperidol and repetitive induction on four immobility responses in mouse and guinea pig.

The modification by haloperidol and repetitive induction on four immobility responses -- tonic immobility, cataleptic immobility, immobility by clamping the neck and dorsal immobility -- were compared in mice and guinea pigs. Without drug, three out of four responses (cataleptic, neck clamp and dorsal immobility) were induced in mice; guinea pigs displayed all four responses. Haloperidol (5 mg/kg i.p.) potentiated the three responses shown by mice, but did not potentiate the four responses in guinea pigs. In both undrugged and haloperidol-treated mice, only the cataleptic immobility response was potentiated by repetition. In guinea pigs, none of the four immobility responses was affected due to repetition, haloperidol or a combination of both. These data are discussed, considering that, although these immobility responses could be mediated by the same neurotransmitters (e.g. dopamine), they are possibly expressed in a differential manner as a function of the kind of stimulus used to trigger the response, characteristics of the species and, in some immobility responses such as cataleptic immobility, as a function of their interaction with habituation or another learning-like process.

Women at altitude: forearm hemodynamics during acclimatization to 4,300 m with alpha(1)-adrenergic blockade.

We hypothesized that blockade of alpha(1)-adrenergic receptors would prevent the rise in peripheral vascular resistance that normally occurs during acclimatization. Sixteen eumenorrheic women were studied at sea level (SL) and at 4,300 m (days 3 and 10). Volunteers were randomly assigned to take the selective alpha(1)-blocker prazosin or placebo. Venous compliance, forearm vascular resistance, and blood flow were measured using plethysmography. Venous compliance fell by day 3 in all subjects (1.39 +/- 0.30 vs. 1.62 +/- 0.43 ml. Delta 30 mmHg(-1) x 100 ml tissue(-1) x min(-1) at SL, means +/- SD). Altitude interacted with prazosin treatment (P < 0.0001) such that compliance returned to SL values by day 10 in the prazosin-treated group (1.68 +/- 0.19) but not in the placebo-treated group (1.20 +/- 0.10, P < 0.05). By day 3 at 4,300 m, all women had significant falls in resistance (35.2 +/- 13.2 vs. 54.5 +/- 16.1 mmHg x ml(-1) x min(-1) at SL) and rises in blood flow (2.5 +/- 1.0 vs. 1.6 +/- 0.5 ml. 100 ml tissue(-1) x min(-1) at SL). By day 10, resistance and flow returned toward SL, but this return was less in the prazosin-treated group (resistance: 39.8 +/- 4.6 mmHg x ml(-1) x min(-1) with prazosin vs. 58.5 +/- 9.8 mmHg x ml(-1) x min(-1) with placebo; flow: 1.9 +/- 0.7 ml. 100 ml tissue(-1) x min(-1) with prazosin vs. 2.3 +/- 0.3 ml x 100 ml tissue(-1) x min(-1) with placebo, P < 0.05). Lower resistance related to higher circulating epinephrine in both groups (r = -0.50, P < 0.0001). Higher circulating norepinephrine related to lower venous compliance in the placebo-treated group (r = -0.42, P < 0.05). We conclude that alpha(1)-adrenergic stimulation modulates peripheral vascular changes during acclimatization.

Erythropoiesis in women during 11 days at 4,300 m is not affected by menstrual cycle phase.

Because the ovarian steroid hormones, progesterone and estrogen, have higher blood levels in the luteal (L) than in the follicular (F) phase of the menstrual cycle, and because of their known effects on ventilation and hematopoiesis, we hypothesized that less hypoxemia and less erythropoiesis would occur in the L than the F phase of the cycle after arrival at altitude. We examined erythropoiesis with menstrual cycle phase in 16 women (age 22.6 +/- 0.6 yr). At sea level, 11 of 16 women were studied during both menstrual cycle phases, and, where comparison within women was available, cycle phase did not alter erythropoietin (n = 5), reticulocyte count (n = 10), and red cell volume (n = 9). When all 16 women were taken for 11 days to 4,300-m altitude (barometric pressure = 462 mmHg), paired comparisons within women showed no differences in ovarian hormone concentrations at sea level vs. altitude on menstrual cycle day 3 or 10 for either the F (n = 11) or the L (n = 5) phase groups. Arterial oxygen saturation did not differ between the F and L groups at altitude. There were no differences by cycle phase on day 11 at 4,300 m for erythropoietin [22.9 +/- 4.7 (L) vs. 18.8 +/- 3.4 mU/ml (F)], percent reticulocytes [1.9 +/- 0.1 (L) vs. 2.1 +/- 0.3% (F)], hemoglobin [13.5 +/- 0.3 (L) vs. 13.7 +/- 0.3 g/100 ml (F)], percent hematocrit [40.6 +/- 1.4 (L) vs. 40.7 +/- 1.0% (F)], red cell volume [31.1 +/- 3.6 (L) vs. 33.0 +/- 1.6 ml/kg (F)], and blood ferritin [8.9 +/- 1.7 (L) vs. 10.2 +/- 0.9 microg/l (F)]. Blood level of erythropoietin was related (r = 0.77) to arterial oxygen saturation but not to the levels of progesterone or estradiol. We conclude that erythropoiesis was not altered by menstrual cycle phase during the first days at 4,300-m altitude.

Interleukin-6 response to exercise and high-altitude exposure: influence of alpha-adrenergic blockade.

Interleukin-6 (IL-6), an important cytokine involved in a number of biological processes, is consistently elevated during periods of stress. The mechanisms responsible for the induction of IL-6 under these conditions remain uncertain. This study examined the effect of alpha-adrenergic blockade on the IL-6 response to acute and chronic high-altitude exposure in women both at rest and during exercise. Sixteen healthy, eumenorrheic women (aged 23.2 +/- 1.4 yr) participated in the study. Subjects received either alpha-adrenergic blockade (prazosin, 3 mg/day) or a placebo in a double-blinded, randomized fashion. Subjects participated in submaximal exercise tests at sea level and on days 1 and 12 at altitude (4,300 m). Resting plasma and 24-h urine samples were collected throughout the duration of the study. At sea level, no differences were found at rest for plasma IL-6 between groups (1.5 +/- 0.2 and 1.2 +/- 0.3 pg/ml for placebo and blocked groups, respectively). On acute ascent to altitude, IL-6 levels increased significantly in both groups compared with sea-level values (57 and 84% for placebo and blocked groups, respectively). After 12 days of acclimatization, IL-6 levels remained elevated for placebo subjects; however, they returned to sea-level values in the blocked group. alpha-Adrenergic blockade significantly lowered the IL-6 response to exercise both at sea level (46%) and at altitude (42%) compared with placebo. A significant correlation (P = 0.004) between resting IL-6 and urinary norepinephrine excretion rates was found over the course of time while at altitude. In conclusion, the results indicate a role for alpha-adrenergic regulation of the IL-6 response to the stress of both short-term moderate-intensity exercise and hypoxia.