Obstetric anaesthesia outcome in obese and non-obese parturients undergoing caesarean delivery: an observational study.

BACKGROUND: Maternal obesity is increasing in prevalence and is associated with an increased risk of perioperative complications. This study evaluates the impact of obesity on perioperative outcomes in parturients undergoing caesarean delivery. METHODS: In this prospective observational study of 1477 consecutive caesarean deliveries, data collected included body mass index, co-morbidities, anaesthetic technique, perioperative complications and patient satisfaction. Outcome measures included obesity prevalence, association of obesity with caesarean delivery, co-morbidities, perioperative complications and patient satisfaction and were compared between the obese and non-obese groups. RESULTS: The prevalence of obesity was 54.3%, including 7.2% morbidly obese. About 61% of parturients who underwent caesarean delivery because of failure to progress in labour or previous caesarean were obese. The overall prevalence of co-morbidity was 10.2% of whom 57.3% were obese. Neuraxial anaesthesia was used in 73.4% and general anaesthesia in 26.6%, similar in obese and non-obese. The epidural failure rate was 4.3% and the spinal failure rate 2.9%. Difficulty in performing neuraxial anaesthesia was greater in obese patients (P=0.004). There was no association between obesity and laryngoscopy grades. Patient satisfaction was similar in the obese and non-obese groups. Postoperative complications were minimal and similar. CONCLUSIONS: Neuraxial anaesthesia was effective for caesarean deliveries in obese and non-obese, in elective and emergency cases. Maternal obesity is associated with increased difficulty in performing neuraxial anaesthesia, but not with increased failure rate. Our study found no differences between obese and non-obese parturients in rate of caesarean deliveries, co-morbidities, indications for delivery or anaesthesia complications.

Epigenetic regulation of tumor suppressors in t(8:21)-containing AML.

The t(8;21) is perhaps the most frequent chromosomal translocation associated with acute myeloid leukemia. The translocation creates a fusion protein that consists of the DNA binding domain of the RUNX1 transcription factor fused to the MTG8 transcriptional co-repressor to create a potent transcriptional repressor. Here, we discuss the possibility that the t(8;21) fusion protein represses tumor suppressors that regulate the RAS signaling pathway and the p53 oncogenic checkpoint.

Power frequency magnetic field exposure and gap junctional communication in Clone 9 cells.

Exposure to a power-frequency magnetic field has been reported to produce a statistically significant inhibition of gap junctional communication (GJC) in Clone 9 cells that have been pre-stressed by treatment with low concentrations of chloral hydrate (CH) [C.F. Blackman, J.P. Blanchard, S.G. Benane, D.E. House, J.A. Elder, Double blind test of magnetic field effects on neurite outgrowth, Bioelectromagnetics, 19 (1998) 204-209]. This observation might provide mechanistic insight into the possible role of electromagnetic fields (EMFs) in the carcinogenic process, since cancer cells frequently show decreased or absent GJC, and tumor promoting chemicals have been observed to inhibit GJC. Magnetic field exposure conditions were 45 Hz, 23.8 microT rms + parallel DC 36.6 microT, for 30 min of exposure. The responses of Clone 9 cells to the GJC-inhibiting effects of the tumor promoter 12-O-tetradecanoylphorbol 13-acetate and the chemical CH were evaluated and compared to reported results [S.G. Benane, C.F. Blackman, D.E. House, Effects of perchloroethylene and its metabolites on intercellular communication in Clone 9 rat liver cells, J. Toxicol. Environ. Health, 48 (1996) 427-437]. Before magnetic field exposure, cells were exposed for 24 h to either 3 (nine experiments) or 5 mM (11 experiments) CH to produce GJC of 67% or 50%, respectively, relative to unexposed controls. GJC was assessed microscopically using the scrape-loading technique and a blinded protocol. No statistically significant effect was observed due to magnetic field exposure with either CH concentration.