Birthing in rural South Australia: The changing landscape over 20 years.

OBJECTIVE: To map trends in the maternity service availability for rural women in South Australia and identify the frequency of women birthing outside of their region of residence. DESIGN: A retrospective review of birth location for rural South Australian women from 1991 to 2010. SETTING: Rural maternity units in South Australia. PARTICIPANTS: Birthing statistics from the Pregnancy Outcomes Statistics Unit in South Australia MAIN OUTCOME MEASURES: Rural birth statistics, including place of birth in relation to place of residence and location of maternity units. RESULTS: Over 60% of maternity units across rural South Australia have closed since 1991. There has been a rise in the percentage of women birthing away from their usual region of residence, rising from 18% in 1991-1995 to 24% in 2006-2010. CONCLUSIONS: This study has revealed that almost one quarter of all women residing in rural South Australia relocate to another area to give birth. This is a significant concern for rural women and their families through the expectation of separation, and for the local health services who might now not have the facilities and skills to manage an unplanned maternity presentation. These concerns need to be considered and addressed in order to provide safe and effective care for child-bearing women regardless of location.

Reduction of post-surgical pericardial adhesions using a pig model.

BACKGROUND: Post-surgical pericardial adhesions pose an increased risk of complications during redo sternotomies. Adhesive tissue formation is a normal response to tissue injury and involves complex patho-physiological processes including the actions of prostaglandins to cause plasma leakage and fibrin formation. The purpose of this study was to assess the ability of two non-steroidal anti-inflammatory agents (Indomethacin and Rofecoxib) and a barrier (Coseal, a polyethylene glycol) to limit adhesion formation following cardiac surgery in a pig model. METHODS: Forty-four piglets were allocated equally to four treatment groups: Group 1: Control, Group 2: intramuscular Indomethacin, Group 3: oral Rofecoxib and Group 4: Coseal sprayed on the heart. A full median sternotomy was performed on each animal and the heart exposed. Adhesions were induced by rubbing tissues with gauze, applying sutures and leaving blood in the pericardial sac before chest closure. Plasma inflammatory markers including prostaglandin E(2) and thromboxane B(2) were measured preoperatively and on Days 2, 5 and 10 after surgery. Eight animals from each group were slaughtered after 12 weeks and 3 after 25 weeks. Adhesions were assessed macroscopically and microscopically. RESULTS: Compared to the Control group, the extent of adhesions was significantly less in all other groups whilst adhesion density was least in the Indomethacin and Coseal groups. Indomethacin and less so Rofecoxib, inhibited the synthesis of prostaglandin E(2) and thromboxane B(2) but there were no significant changes in other inflammatory markers. CONCLUSIONS: We conclude that systemic Indomethacin, and locally applied Coseal are suitable methods to markedly reduce pericardial and retrosternal adhesions.

Quantitative determination of recombinant bovine somatotropin in commercial shrimp feed using a competitive enzyme-linked immunosorbent assay.

Recombinant bovine somatotropin (rbST), also known as growth hormone, is used to enhance production and development of animals within the agriculture and aquaculture industries. Its use is controversial because of its potential effects on human and animal health. To screen for rbST in shrimp feed, a competitive enzyme-linked immunosorbent assay (ELISA) with an inhibition step was developed. Sample and rbST antibody (rabbit anti-rbST) were incubated at room temperature for 30 min. Subsequently, this competitive reaction was transferred to a microplate coated with rbST, using goat antirabbit IgG linked with horseradish peroxidise as the secondary antibody. Substrates for peroxidise were added, and the absorbance at 410 nm was determined. The applicability of the method was assessed using rbST extracted from "spiked" shrimp feed samples. The assay was reproducible and linear with R(2) values greater than 0.98 over the standard curve range of 20-500 microg/g. The intra- and interday precisions expressed as relative standard deviations were 3.4 and 5.3%, respectively. The mean recovery from 15 spiked feed samples was 105%. This assay will be a valuable tool for quantitative detection of rbST by both governments and commercial companies and can be modified for other types of feed.

Seroreactivity against streptococcal DRS (distantly related to SIC) protein is a predictor for end-stage renal failure.

We hypothesized that immunoreactivity against antigens from nephritic strains of Streptococcus pyogenes may be elevated in patients with end-stage renal failure (ESRF). Additionally, we investigated whether a difference in seroreactivity exists between nonindigenous and indigenous (Aboriginal/Torres Strait Islander) patients. To examine these possibilities, antibodies against potentially nephritogenic proteins, streptokinase (Ska1) (from M1), streptococcal pyrogenic exotoxin type B (SpeB) (from M1), the streptococcal inhibitor of complement-mediated cell lysis (SIC) (from M1) and its two variants, closely related to SIC (CRS) (from M57) and distantly related to SIC (DRS) (from M12) were determined in 66 patients and 31 healthy controls by enzyme-linked immunosorbent assays. A significantly higher proportion of patients compared to controls were seropositive to Ska1 (P = 0.004), DRS (P = 0.0003), CRS (P = 0.001), and SIC (P = 0.018). Regression analysis showed that seroreactivity to DRS (r(2) = 0.85, P = 0.001) predicted the development of ESRF and that being diabetic was positively associated with being an ESRF patient (r(2) = 0.37, P < 0.0001) and being indigenous (r(2) = 0.47, P < 0.0001). These results suggest that these ESRF patients were exposed to strains of S. pyogenes that secrete Ska1, DRS, CRS, and SIC and may have pathological significance. No significant difference was observed between the indigenous patients and nonindigenous patients.

High-performance liquid chromatographic assay of indomethacin in porcine plasma with applicability to human levels.

A high-performance liquid chromatography (HPLC) assay is described for the determination of indomethacin in porcine plasma using acetonitrile to precipitate plasma proteins and for the one-step extraction. Calibration curves (using the internal standard method) are linear (r2 > 0.98) over the concentration range of 50.0 to 3000 ng/mL in both mobile phase and plasma. Precision, expressed as the inter- and intraday coefficient of variation (n = 5), is < 7% on the same day and < 5% between days at each plasma control sample of 300, 1000, and 3000 ng/mL, respectively. System precision, calculated as the coefficient of variation (n = 5), is < 7% at 3000 ng/mL of indomethacin, and the limit of quantitation in plasma is 50 ng/mL. The absolute recovery for both indomethacin and the internal standard (mefenamic acid) from plasma is over 97% (n = 3), and the concentrations do not deviate more than -2.9% to 2.4% from their actual values. The specificity of the method is confirmed. This technique is thus reported to be both rapid and specific. The real advantage is the small sample volume required (500 microL), which allows it to be considered for the quantitation of indomethacin in plasma from paediatric patients.