Stopping smoking in pregnancy: effect of a self-help manual in controlled trial

For medical reasons, encouraging women to stop smoking during pregnancy and post partum has high priority. Many smokers want to stop smoking but decline clinical treatment when it is offered. The aim of this study was to find a method which was accepted by a large number of smokers, had a high success rate and, at the same time, required little involvement from personnel. For one year, all pregnant smokers attending 13 of the 14 public health maternity clinics in Gothenburg for their first appointment were invited to participate in this study. Inclusion criteria were daily smoking, a gestational age of less than 12 weeks and ability to understand Swedish. A total of 745 women was registered, but 22 of them stopped smoking before the treatment. The remaining women were randomized to a treatment group (n = 492) and a control group (n = 231). Of the 492 women in the treatment group 417 (85%) accepted the idea of using the self-help manual written especially for pregnant women and given to each woman in the treatment group by the obstetrician. Overall 10.4% of the treatment group stopped smoking up to 8 weeks after delivery compared with 5.2% of the control group (odds ratio 0.5, 95% CI 0.2-0.9). The ex-smoking status was verified by measurement of thiocyanate in blood. The self-help manual had a high acceptance rate and a success rate that was double the rate in the control group.

Sequence and developmental expression of the mRNA encoding the seleno-protein of the sperm mitochondrial capsule in the mouse

We have characterized cDNA clones encoding the selenium-containing polypeptide of the keratinous mitochondrial capsule in mouse sperm. The longest open reading frame encodes a polypeptide 143 amino acids long which contains 21% cysteine and 27% proline and closely resembles the size and amino acid composition of bull mitochondrial capsule seleno-protein (V. Pallini, B. Baccetti, and A. G. Burrini, 1979, in "The Spermatozoon," D. W. Fawcett and J. M. Bedford, Eds., pp. 141-151, Urban & Schwartzenberg, Baltimore/Munich). The reading frame encoding the mitochondrial capsule seleno-protein ends with an amber stop codon suggesting that selenium is not incorporated cotranslationally into the protein by an opal suppressor selenocysteyl-tRNA as has been found for several eukaryotic and bacterial proteins. Northern blots using RNA extracted from purified spermatogenic cells and staged prepuberal mice suggest that the mitochondrial capsule seleno-protein mRNA is first transcribed in late meiotic cells and that the levels of the mRNA increase after meiosis in early haploid cells. Southern blots demonstrate that there is one copy of the gene in the mouse genome. The identification of this cDNA clone, in combination with previous work (K. C. Kleene, 1989, Development 106, 367-373) demonstrates that the mRNA for the mitochondrial capsule seleno-protein is translationally repressed with long homogenous poly(A) tracts in round spermatids and translationally active with shortened heterogenous poly(A) tracts in elongating spermatids.

Seasonal affective disorder and visual impairment: two case studies

Winter depressive episodes in patients with seasonal affective disorder are induced by light deficiency and are successfully treated by enhancing environmental light. The authors investigated the role of abnormal visual information processing in the genesis of seasonal affective disorder symptoms by examining two patients with impaired vision and recurrent winter depressions. The first patient developed winter depressions after developing a traumatic cataract in one eye, and was helped by light therapy. The second patient, fully blind since she was 1 year old, nonetheless suffered as an adult from winter depressions, which responded to bright--but not to dim--light treatment. The authors discuss the implications of these findings.

Solid surfactant solutions of active ingredients in sugar esters

This paper describes the preparation of solid solutions of ciclosporin as model solubilizate in water-soluble sugar esters, which are solid, biodegradable, and nontoxic surfactants. Sugar esters were found to be excellent solubilizers for poorly water-soluble drugs such as ciclosporin. Such systems are suitable for the preparation of solid dosage forms for the purpose of oral administration. Addition of water to the solid solutions yields clear solutions of the solubilizate.

Clinical findings and results of operative treatment in ilioinguinal nerve entrapment syndrome

Women complaining of lower abdominal and pelvic pain were tested for the presence of an ilioinguinal nerve entrapment. Forty-six women were considered to fulfill the requirements for this syndrome, five of them bilaterally. In the 51 nerves tested common findings were hyperaesthesia (88%), dysaesthesia (53%) and pain pressure at the nerve exit (75%); hypoaesthesia was rare (6%). A prerequisite for an operation was a positive result of a block with local anaesthesia. Good to excellent results of an operative approach, usually transection of the nerve, were noted after 39 procedures (76%). Some improvement was reported after six procedures whereas the operation had no effect in six others. A probable cause of the neuralgia could be found in only six women. Ilioinguinal nerve entrapment should be considered early in the differential diagnosis of lower abdominal and pelvic pain.

Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive. PVpos and PVneg of combined scintigraphy and ultrasonography were 100% when the two test results were identical (n = 34). In patients with one test inconclusive or discrepancy between scintigraphy and ultrasonography, PVpos and PVneg were 79% and 67%, respectively (n = 20). The results suggest that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair basis for diagnostic and therapeutic decision. In case of discrepancy between ultrasonography and scintigraphy the diagnosis should be reevaluated.

Anticardiolipin antibodies and complement in ninety-nine women with habitual abortion

Immunologic investigations were performed on sera from 99 women with habitual abortion (three or more consecutive miscarriages). All were considered healthy and clinical investigations had not revealed any cause for the miscarriages. Sixty-eight were considered to have primary habitual abortion whereas 31 had secondary habitual abortion. Increased anticardiolipin antibody levels were found in 42 patients. None had a primary diagnosis of systemic lupus erythematosus, but at follow-up studies one of them fulfilled the diagnostic criteria of systemic lupus erythematosus. Ten sera, all from patients with primary habitual abortion, showed high anticardiolipin antibody values (greater than or equal to 10 units) concomitant with significantly lower levels of complement factor C4 than those found in sera with moderate or normal anticardiolipin antibody levels. There was no indication of genetic defects explaining the low C4 values, which could be explained at least in part by an activation of complement by the classical pathway.

The prospective diagnostic value of real-time cholecystosonography

A series of 82 consecutive patients scheduled for operation, with pre-operatively obtained P.O. cholecystography and in some cases also I.V. cholangiography, is presented. All patients had cholecystosonography performed "blindly" the day prior to the operation (76 had a cholecystectomy and six had a vagotomy). Based upon the operative findings, the diagnostic value of ultrasonic examination for gallstones can be calculated to predictive value of positive test--1.00; predictive value of negative test--0.71. The diagnostic failures are discussed but it is not possible to predict which patients will benefit more from peroral cholecystography rather than from ultrasound. It is concluded that cholecystosonography is a safe alternative to peroral cholecystography.

Progesterone treatment of premenstrual tension--a double blind study

Fifteen women with moderate to severe premenstrual symptoms, defined and graded according to a recently developed scoring system, took part in a double blind study of the effect of progesterone on premenstrual symptoms. The dosage was 100 mg progesterone twice daily delivered in vaginal pessaries. The women were improved with a statistically significant decrease in their scores by progesterone as well as by placebo treatment. There was no statistically significant difference between the two regimes.

Renal arteriovenous fistula associated with fibromuscular dysplasia

A case is reported of a woman with long-standing progressive hypertension and an abdominal bruit who on angiography demonstrated fibromuscular dysplasia of the right renal artery and an arteriovenous fistula in the upper pole of the right kidney. The various causes of renal arteriovenous fistula are reviewed. The relationship of mural aneurysms seen in fibromuscular dysplasia and the formation of arteriovenous fistulas by rupture of these aneurysms is discussed. Review of the English literature indicates a probable causal relationship between fibromuscular dysplasia of the renal arteries and intrarenal arteriovenous fistulas.

Premenstrual complaints II. Influence of oral contraceptives

The prevalence of individual premenstrual symptoms was studied in a randomly selected group of 217 women taking oral contraceptives (OC). The results were compared with corresponding data from 595 women not using the pill. the analyses included six different mental and somatic symptoms defined and graded in severity and related to age. It was found that OC had a beneficial effect on the premenstrual tension symptoms (PMT) in all age groups except in the youngest group (18 years), in which the tendency was rather the opposite. Within the total sample of women, users of OC were significantly less frequently absent from work. The present results are in agreement with those of most earlier studies, provided that age is taken into account.