Hesperetin protects against diesel exhaust particles-induced cardiovascular oxidative stress and inflammation in Wistar rats.

Air particulate matter exposure has been linked to cardiovascular and atherosclerosis as a result of increase oxidative stress and inflammatory response. This study aims to determine the effect of the use of hesperetin (HESP) as a therapeutic agent to mitigate the cardiovascular oxidative and pro-inflammatory effects of diesel exhaust particles in Wistar rats. DEP was collected from an Iveco cargo engine truck, and n-hexane fraction (hDEP) was obtained. Forty Wistar strains of male albino rats (6 weeks) were divided into 8 groups: control group received DMSO and CMC-Na; other groups received either n-hexane extract of DEP (0.064 or 0.640 mg/kg hDEP) or Standard Reference Material 2975 (0.064 mg/kg hSRM) in the presence or absence of 200 mg/kg HESP. Extracts were administered orally. Serum lipids, lipid peroxidation (LPO), conjugated dienes (CDs), and GSH levels were determined. Also, inflammatory cytokines, PCSK-9, LDL-receptor, and antioxidant genes expression were assessed by RT-PCR in both the heart and aorta. The molecular interaction of targeted proteins with HESP was assessed by the in silico approach. Extracts of DEP caused a significant (p < 0.001) increase in serum lipids but significantly decreased HDL-CHOL. It also increased CDs and MDA levels but decreased GSH levels. In addition, the particulate extracts caused a significant (p < 0.001) increase in pro-inflammatory genes expression in the heart and aorta but significantly decreased IL-10 and LDL-R gene expressions. Pre-treatment with hesperetin significantly reversed all these effects. This study shows that hesperetin has the ability to protect against DEP-induced oxidative stress and inflammation in the cardiovascular system.

The cardiovascular protective effects of rooibos (Aspalathus linearis) extract on diesel exhaust particles induced inflammation and oxidative stress involve NF-κB- and Nrf2-dependent pathways modulation.

Studies have shown that diesel exhaust particles (DEP) induced oxidative stress and inflammation. This present study examined the molecular effects of aqueous rooibos extract (RE) on the cardiovascular toxic effect of methanol extract of DEP in exposed Wistar rats. The results showed that DEP caused significant (p < 0.001) increase in MDA and CDs levels in the aorta and heart but this increase was significantly (p < 0.001) attenuated by rooibos extract. DEP induced IL-8, TNFα, IL-1ß and decreased IL-10 gene expressions, all of which were reversed in the presence of rooibos extract. The expression of NF-κB, and IκKB genes were also significantly (p < 0.001) induced by DEP in both tissues, but pre-treatment with RE attenuated these effects. In contrast, DEP repressed IκB mRNA level, which was significantly (p < 0.001) reversed by rooibos extract pre-treatment. In addition, pre-treatment with rooibos extract attenuated the increased Nrf2 and HO-1 mRNA levels caused by DEP. This indicates the potential of rooibos extract to protect against DEP-induced cardiovascular toxicity.

Pelvic and hip kinematics during single-leg drop-landing are altered in sports participants with long-standing groin pain: A cross-sectional study.

OBJECTIVES: The aim of this study was to determine the differences in three-dimensional pelvic and hip kinematics during a single-leg drop-landing task in active sports participants with long-standing groin pain compared to healthy matched controls. DESIGN: This was a descriptive study incorporating a cross-sectional design. SETTING: The study was conducted at the Unit for Human Movement Analysis, Stellenbosch University, South Africa. PARTICIPANTS: The study sample was comprised of 20 male club level soccer, rugby, running and cycling participants between the ages of 18 and 55 years. Ten cases with long-standing groin pain and ten asymptomatic matched controls participated. MAIN OUTCOME MEASURES: Three-dimensional pelvic and hip kinematics were captured with an optical motion capture system during a single-leg drop-landing task. RESULTS: Participants with groin pain landed with more downward lateral pelvic tilt (0.77°, p = 0.01, r = 0.35), hip abduction (2.05°, p < 0.001. r = 0.49), and hip external rotation (0.86°, p = 0.03, r = 0.29) at initial contact and more pelvic internal rotation (1.06°, p = 0.02, r = 0.30) at lowest vertical position than the healthy controls. CONCLUSIONS: Sports participants with long-standing groin pain have altered pelvic and hip kinematics during single-leg drop-landing compared to healthy controls. The kinematic differences may contribute towards the persistent nature of groin pain, although these strategies may also be present as a result of the presence or the expectation of pain.

Maternal mood and concordant maternal and infant salivary cortisol during heel lance while in kangaroo care.

BACKGROUND: Maternal kangaroo care (MKC) is a naturalistic intervention that alleviates neonatal pain, and mothers are assumed to play a stress regulatory role in MKC. Yet, no MKC infant pain study has examined relationship between maternal and infant stress reactivity concurrently, or whether post-partum depression and/or anxiety (PPDA) alters maternal and neonatal stress response and the regulatory effects of MKC. OBJECTIVES: To examine the concordance of salivary cortisol reactivity between 42 mothers and their stable preterm infants during routine infant heel lance (HL) while in MKC and to compare salivary cortisol between groups of mothers with and without PPDA and their infants. METHODS: Maternal and infant salivary cortisol samples were collected pre-HL and 20 min post-HL with two additional maternal samples at night and in the morning. Mothers and infants were allocated to with PPDA versus without PPDA study groups on the basis of maternal post-natal mental health assessment scores. RESULTS: Higher mothers' cortisol pre-HL was weakly associated with higher infants' salivary cortisol in response to the HL procedure. Maternal depression and/or anxiety were not associated with infants' cortisol. During HL, both groups of mothers and infants showed no change in salivary cortisol. CONCLUSIONS: Concordance between mother and infant salivary cortisol supports the maternal stress regulatory role in MKC. MKC may have stress regulatory benefits for mothers and their preterm infants during HL independent of PPDA. Future MKC studies that target mothers with altered mood will help to build on these findings.

Oral betamimetics for maintenance therapy after threatened preterm labour.

BACKGROUND: Some women who have threatened to give birth prematurely, subsequently settle. They may then take oral tocolytic maintenance therapy to prevent preterm birth and to prolong gestation. OBJECTIVES: To assess the effects of oral betamimetic maintenance therapy after threatened preterm labour for preventing preterm birth. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Trials Register (June 2005) and MEDLINE (from 1966 to August 2003). SELECTION CRITERIA: Randomised controlled trials comparing oral betamimetic with alternative tocolytic therapy, placebo or no therapy, for maintenance following treatment of threatened preterm labour. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the selection criteria and carried out data extraction and quality assessment of studies. MAIN RESULTS: Eleven randomised controlled trials (RCTs) were included. No differences were seen for admission to the neonatal intensive care unit when betamimetics were compared with placebo (relative risk (RR) 1.29, 95% confidence interval (CI) 0.64 to 2.60; one RCT of terbutaline with 140 women) or with magnesium (RR 0.80, 95% CI 0.43 to 1.46; one RCT of 137 women). The rate of preterm birth (less than 37 weeks) showed no significant difference in four RCTs, two comparing ritodrine with placebo/no treatment and two comparing terbutaline with placebo/no treatment (RR 1.08, 95% CI 0.88 to 1.32, 384 women). No differences between betamimetics and placebo, no treatment or other tocolytics were seen for perinatal mortality and morbidity outcomes. Some adverse effects such as tachycardia were more frequent in the betamimetics groups than the groups allocated to placebo, no treatment or another type of tocolytic. AUTHORS' CONCLUSIONS: Available evidence does not support the use of oral betamimetics for maintenance therapy after threatened preterm labour.

Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more).

BACKGROUND: Prelabour rupture of membranes at term is managed expectantly or by elective birth, but it is not clear if waiting for birth to occur spontaneously is better than intervening. OBJECTIVES: To assess the effects of planned early birth versus expectant management for women with term prelabour rupture of membranes on fetal, infant and maternal wellbeing. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (November 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2004), MEDLINE (1966 to November 2004) and EMBASE (1974 to November 2004). SELECTION CRITERIA: Randomised or quasi-randomised trials of planned early birth compared with expectant management in women with prelabour rupture of membranes at 37 weeks' gestation or more. DATA COLLECTION AND ANALYSIS: Two review authors independently applied eligibility criteria, assessed trial quality and extracted data. A random-effects model was used. MAIN RESULTS: Twelve trials (total of 6814 women) were included. Planned management was generally induction with oxytocin or prostaglandin, with one trial using homoeopathic caulophyllum. Overall, no differences were detected for mode of birth between planned and expectant groups: relative risk (RR) of caesarean section 0.94, 95% confidence interval (CI) 0.82 to 1.08 (12 trials, 6814 women); RR of operative vaginal birth 0.98, 95% 0.84 to 1.16 (7 trials, 5511 women). Significantly fewer women in the planned compared with expectant management groups had chorioamnionitis (RR 0.74, 95% CI 0.56 to 0.97; 9 trials, 6611 women) or endometritis (RR 0.30, 95% CI 0.12 to 0.74; 4 trials, 445 women). No difference was seen for neonatal infection (RR 0.83, 95% CI 0.61 to 1.12; 9 trials, 6406 infants). However, fewer infants under planned management went to neonatal intensive or special care compared with expectant management (RR 0.72, 95% CI 0.57 to 0.92, number needed to treat 20; 5 trials, 5679 infants). In a single trial, significantly more women with planned management viewed their care more positively than those expectantly managed (RR of "nothing liked" 0.45, 95% CI 0.37 to 0.54; 5031 women). AUTHORS' CONCLUSIONS: Planned management (with methods such as oxytocin or prostaglandin) reduces the risk of some maternal infectious morbidity without increasing caesarean sections and operative vaginal births. Fewer infants went to neonatal intensive care under planned management although no differences were seen in neonatal infection rates. Since planned and expectant management may not be very different, women need to have appropriate information to make informed choices.

Treatment for women with postpartum iron deficiency anaemia.

BACKGROUND: Postpartum anaemia is associated with breathlessness, tiredness, palpitations and maternal infections. Blood transfusions or iron supplementation have been used in the treatment of iron deficiency anaemia. Recently other anaemia treatments, in particular erythropoietin therapy, have also been used. OBJECTIVES: To assess the clinical effects of treatments for postpartum anaemia, including oral, intravenous or subcutaneous iron/folate supplementation and erythropoietin administration, and blood transfusion. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (30 May 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to March 2003), EMBASE (1980 to March 2003), Current Contents and ACP Journal Club (from inception to March 2003). SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing therapy for postpartum iron deficiency anaemia (oral, intravenous or subcutaneous administration of iron, folate, erythropoietin or blood transfusion) with placebo, another treatment or no treatment. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Six included RCTs involving 411 women described treatment with erythropoietin or iron as their primary interventions. No RCTs were identified that assessed treatment with blood transfusion. Few outcomes relating to clinical maternal and neonatal factors were reported: studies focused largely on surrogate outcomes such as haematological indices. Overall, the methodological quality of the included RCTs was reasonable; however, their usefulness in this review is restricted by the interventions and outcomes reported. When compared with iron therapy only, erythropoietin increased the likelihood of lactation at discharge from hospital (1 RCT, n = 40; relative risk (RR) 1.90, 95% confidence interval (CI) 1.21 to 2.98). No apparent effect on need for blood transfusions was found, when erythropoietin plus iron was compared to treatment with iron only (2 RCTs, n = 100; RR 0.20, 95% CI 0.01 to 3.92), although the RCTs may have been of insufficient size to rule out important clinical differences. Haematological indices (haemoglobin and haemocrit) showed some increases when erythropoietin was compared to iron only, iron and folate, but not when compared with placebo. REVIEWERS' CONCLUSIONS: There is some limited evidence of favourable outcomes for treatment of postpartum anaemia with erythropoietin. However, most of the available literature focuses on laboratory haematological indices, rather than clinical outcomes. Further high-quality trials assessing the treatment of postpartum anaemia with iron supplementation and blood transfusions are required. Future trials may also examine the significance of the severity of anaemia in relation to treatment, and an iron-rich diet as an intervention.

[Uterine rupture at the Niamey Central Maternity Reference Center, Nigeria. Epidemiologic features and prevention strategies]. / La rupture utérine à la Maternité Centrale de Référence de Niamey (Niger). Aspects épidémiologiques et stratégies de prévention.

The authors have documented 50 cases of U.R., out 2,151 normal deliveries. During the same period, 614 surgeries for caesarean sections were performed. The U.R. frequency has been estimated at 1.80%. 98% of the U.R. were referred to us from outside in the vicinity maternities of Niamey. The maximum number of frequencies occurs between the ages of 15-42 years, and in decreasing order, among multiparas (with a parity of 5 and above). Uterine scars are among the principal causing factors. Sub total hysterectomy was the most widely used surgical method (60%). Among the 50 cases, 8 maternal deaths (16%) and 48 fatal deaths were reported (96%). The average length of stay in hospital was between 4 and 7 days. The shortest was 5 day and the longest 17 days. In order to alleviate this dramatic situation, the authors suggest the following measures: the implementation of a family planning programme (to discourage multiparity) a wide information campaign of the population, the insurance of a better treatment of uterus scars, the building of surgical units closer to rural areas, the provision of a better equipment to medical centres, the retraining of medical personnel.