The Impact of Hospitalization on Physical Activity During Pregnancy

The concept of prenatal physical activity has transitioned from a potentially risky behaviour to a prescription to improve maternal-fetal health. Pregnant women who are hospitalized because of a complication should continue to engage in light activities of daily living given the known adverse effects of maternal bedrest. Because the amount physical activity performed by pregnant women while in hospital not been documented; we compared levels of physical activity between women who were and were not hospitalized during pregnancy. We found that hospitalized pregnant women self-impose bedrest even in the absence of a medical recommendation.

Age, body mass index, and weight gain do not increase sympathetic activity during pregnancy

Associations between prepregnancy body mass index, gestational weight gain, maternal age, and basal sympathetic nervous system activity (SNA) in normotensive pregnant women have not been explored. Retrospective analysis of microneurography records from 74 normotensive pregnant women during their third trimester indicated that although pregnancy is associated with rapid weight gain, this does not influence SNA. There were also no associations between maternal age and SNA, but more studies are needed to confirm this interpretation.

Novelty Neither age nor excessive weight gain appears to influence sympathetic activity during normotensive pregnancy.

Sympathetic nervous system activity and reactivity in women with gestational diabetes mellitus

INTRODUCTION

Gestational diabetes mellitus (GDM) is associated with vascular dysfunction. Sympathetic nervous system activity (SNA) is an important regulator of vascular function, and is influenced by glucose and insulin. The association between GDM and SNA (re)activity is unknown. We hypothesize that women with GDM would have increased SNA during baseline and during stress.

METHODS

Eighteen women with GDM and 18 normoglycemic pregnant women (controls) were recruited. Muscle SNA (MSNA; peroneal microneurography) was assessed at rest, during a cold pressor test (CPT) and during peripheral chemoreflex deactivation (hyperoxia). Spontaneous sympathetic baroreflex gain was quantified versus diastolic pressure at rest and during hyperoxia.

RESULTS

Age, gestational age (third trimester) and pre-pregnancy body mass index and baseline MSNA was not different among the groups. Women with GDM had a similar increase in MSNA, but a greater pressor response to CPT compared to controls (% change in MAP 17 ± 7% vs. 9 ± 9%; p = .004). These data are consistent with a greater neurovascular transduction in GDM (% change in total peripheral resistance/% change in burst frequency [BF]: 15.9 ± 30.2 vs. -5.2 ± 16.4, p = .03). Interestingly, women with GDM had a greater reduction in MSNA during hyperoxia (% change in BF -30 ± 19% vs. -6 ± 17%; p = .01).

CONCLUSION

Women diagnosed with GDM have similar basal SNA versus normoglycemic pregnant women, but greater neurovascular transduction, meaning a greater influence of the sympathetic nerve activity in these women. We also document evidence of chemoreceptor hyperactivity, which may influence SNA in women with GDM but not in controls.

Blunted sympathetic neurovascular transduction during normotensive pregnancy

KEY POINTS

Normotensive pregnancy is associated with elevated sympathetic nervous system activity yet normal or reduced blood pressure. It represents a unique period of apparent healthy sympathetic hyperactivity. The present study models the blood pressure and heart rate (ECG R-R interval) responses to fluctuations in sympathetic nervous system activity aiming to understand neurocardiovascular transduction. The reported data clearly demonstrate that transduction of sympathetic nervous system signalling to systemic cardiovascular outcomes is reduced in normotensive pregnancy. These data are important for understanding how blood pressure regulation adapts during normotensive pregnancy and set the foundation for exploring similar mechanisms in hypertensive pregnancies.

ABSTRACT

Previously, we described sympathetic nervous system hyperactivity yet decreased blood pressure responses to stress in normotensive pregnancy. To address the hypothesis that pregnant women have blunted neurocardiovascular transduction we assessed the relationship between spontaneous bursts of sympathetic nerve activity (SNA) and fluctuations in mean arterial blood pressure and R-R interval. Resting SNA, blood pressure and ECG were obtained in pregnant (third trimester, n = 18) and non-pregnant (n = 18) women matched for age and pre-/non-pregnant body mass index. Custom software modelled beat-by-beat pressure (photoplethysmography) and R-R interval in relation to sequences of SNA bursts and non-bursts (peroneal microneurography). Sequences were grouped by the number of bursts and non-bursts [singlets, doublets, triplets and quadruplet (four or more)] and mean blood pressure and R-R interval were tracked for 15 subsequent cardiac cycles. Similar sequences were overlaid and averaged. Peak mean pressure in relation to sequences of SNA was reduced in pregnant vs. non-pregnant women (doublets: 1.6 ± 1.1 mmHg vs. 3.6 ± 3.1 mmHg, P < 0.05; triplets: 2.4 ± 1.2 mmHg vs. 3.4 ± 2.1 mmHg, P < 0.05; quadruplets: 3.0 ± 1.0 mmHg vs. 5.5 ± 3.7 mmHg, P < 0.05). The nadir R-R interval following burst sequences was also smaller in pregnant vs. non-pregnant women (singlets: -0.01 ± 0.01 s vs. -0.04 ± 0.04 s, P < 0.05; doublets: -0.02 ± 0.03 s vs. -0.05 ± 0.04 s, P < 0.05; triplets: -0.02 ± 0.01 s vs. -0.07 ± 0.04 s, P < 0.05; quadruplets: -0.01 ± 0.01 s vs. -0.09 ± 0.09 s, P < 0.05). There were no differences between groups in the mean arterial pressure and R-R interval responses to non-burst sequences. Our data clearly indicate blunted systemic neurocardiovascular transduction during normotensive pregnancy. We propose that blunted transduction is a positive adaptation protecting pregnant women from the cardiovascular consequences of sympathetic hyperactivity.

GreenCentre Canada: an experimental model for green chemistry commercialization

Promising chemistry technologies are difficult to commercialize because of the “commercialization gap” that exists between academia and industry. This is especially important for discoveries in the area of green chemistry that can only fulfil their environmental and societal promise if they are successfully adopted by the chemical industry. However, the existing technology transfer model for academic commercialization is not well-suited for the highly sector-specific and long-term needs of chemistry technologies. GreenCentre Canada was founded in 2009 as a response to these commercialization needs: a chemistry-focused centre with sector-specific expertise (a Sector-specific Commercialization Centre, or SCC), including both highly trained scientists and business development professionals. GreenCentre works with academic researchers throughout Canada and internationally to evaluate, de-risk, scale-up, and optimize early-stage technologies in order to demonstrate the technology potential to industrial buyers or customers. Additionally, GreenCentre’s work extends to small- and medium-sized enterprises at a more advanced stage in the technology development process, as well as large multinational enterprises that are well-established within the chemical industry but also benefit from the centre’s expertise and resources. GreenCentre Canada represents a unique model for the development and commercialization of green chemistry technologies so that they may realize their environmental and societal benefits.

Tailoring Surface Frustrated Lewis Pairs of In2O3-x (OH)y for Gas-Phase Heterogeneous Photocatalytic Reduction of CO2 by Isomorphous Substitution of In3+ with Bi3

Frustrated Lewis pairs (FLPs) created by sterically hindered Lewis acids and Lewis bases have shown their capacity for capturing and reacting with a variety of small molecules, including H2 and CO2, and thereby creating a new strategy for CO2 reduction. Here, the photocatalytic CO2 reduction behavior of defect-laden indium oxide (In2O3-x (OH) y ) is greatly enhanced through isomorphous substitution of In3+ with Bi3+, providing fundamental insights into the catalytically active surface FLPs (i.e., In-OH···In) and the experimentally observed "volcano" relationship between the CO production rate and Bi3+ substitution level. According to density functional theory calculations at the optimal Bi3+ substitution level, the 6s2 electron pair of Bi3+ hybridizes with the oxygen in the neighboring In-OH Lewis base site, leading to mildly increased Lewis basicity without influencing the Lewis acidity of the nearby In Lewis acid site. Meanwhile, Bi3+ can act as an extra acid site, serving to maximize the heterolytic splitting of reactant H2, and results in a more hydridic hydride for more efficient CO2 reduction. This study demonstrates that isomorphous substitution can effectively optimize the reactivity of surface catalytic active sites in addition to influencing optoelectronic properties, affording a better understanding of the photocatalytic CO2 reduction mechanism.

Exercise as a therapeutic intervention to optimize fetal weight

The Developmental Origins of Health and Disease suggest the in utero environment programs offspring obesity and cardiovascular disease. Therefore, there is a need to implement safe therapeutic interventions that do not involve the intake of medications or biological products during pregnancy that can improve maternal and fetal health. Prenatal exercise is established to promote maternal and fetal health. It is generally recommended that women accumulate at least 150 min per week of moderate-intensity exercise. It has been demonstrated that prenatal exercise maintains healthy weight gain and improves maternal glucose control, maternal cardiac autonomic control, placental efficiency (increases angiogenesis, downregulates genes involved in fatty acid transport and insulin transport across the placenta, and upregulates genes involved in amino acid transport across the placenta), and oxidative stress. These adaptations following exercise improve maternal metabolism and provide adequate uteroplacental perfusion. In this review, we will focus on exercise as a therapeutic intervention to optimize fetal weight. It has been established that prenatal exercise does not increase the risk of having a small for gestational age baby. To the contrary, prenatal exercise has been associated with the prevention of excessive fat accumulation in the newborn and the maintenance of fetal muscle mass.

Sympathetic neurovascular regulation during pregnancy: A longitudinal case series study

NEW FINDINGS

What is the main observation in this case? The main observation of this case report is that during pregnancy there is a progressive sympatho-excitation in basal conditions and under stress, which is offset by a concurrent reduction in neurovascular transduction. Strong correlations between autonomic nervous system activity and sex hormones (oestrogen and progesterone), vasopressin and aldosterone were found. What insights does it reveal? Our findings suggest that hormonal surges might be associated with central sympathetic activation.

ABSTRACT

The adaptations of sympathetic nerve activity (SNA) during pregnancy remain poorly understood. An increase in blood volume, cardiac output and SNA, with a concomitant drop in total peripheral resistance (TPR), suggest that during pregnancy there is a reduced transduction of SNA into TPR. Most of these findings have originated from cross-sectional studies; thus, we conducted a longitudinal assessment of SNA and TPR in two participants. Measurements were made before pregnancy (early follicular phase), on four occasions during pregnancy and at 2 months postpartum. Mean arterial pressure and cardiac output were used to calculate TPR. The SNA was measured using microneurography (peroneal nerve). There was a gestation-dependent increase in SNA burst frequency (r²  = 0.96, P = 0.009). Neurovascular transduction, however, decreased by 53% in both women. Sympathetic hyperactivity was reversed postpartum, whereas neurovascular transduction remained lower. These longitudinal data highlight the progressive sympatho-excitation of pregnancy, which is offset by a concurrent reduction in neurovascular transduction.

Visible and Near-Infrared Photothermal Catalyzed Hydrogenation of Gaseous CO2 over Nanostructured Pd@Nb2O5

The reverse water gas shift (RWGS) reaction driven by Nb2O5 nanorod-supported Pd nanocrystals without external heating using visible and near infrared (NIR) light is demonstrated. By measuring the dependence of the RWGS reaction rates on the intensity and spectral power distribution of filtered light incident onto the nanostructured Pd@Nb2O5 catalyst, it is determined that the RWGS reaction is activated photothermally. That is the RWGS reaction is initiated by heat generated from thermalization of charge carriers in the Pd nanocrystals that are excited by interband and intraband absorption of visible and NIR light. Taking advantage of this photothermal effect, a visible and NIR responsive Pd@Nb2O5 hybrid catalyst that efficiently hydrogenates CO2 to CO at an impressive rate as high as 1.8 mmol gcat-1 h-1 is developed. The mechanism of this photothermal reaction involves H2 dissociation on Pd nanocrystals and subsequent spillover of H to the Nb2O5 nanorods whereupon adsorbed CO2 is hydrogenated to CO. This work represents a significant enhancement in our understanding of the underlying mechanism of photothermally driven CO2 reduction and will help guide the way toward the development of highly efficient catalysts that exploit the full solar spectrum to convert gas-phase CO2 to valuable chemicals and fuels.

Spatial Separation of Charge Carriers in In2O3-x(OH)y Nanocrystal Superstructures for Enhanced Gas-Phase Photocatalytic Activity

The development of strategies for increasing the lifetime of photoexcited charge carriers in nanostructured metal oxide semiconductors is important for enhancing their photocatalytic activity. Intensive efforts have been made in tailoring the properties of the nanostructured photocatalysts through different ways, mainly including band-structure engineering, doping, catalyst-support interaction, and loading cocatalysts. In liquid-phase photocatalytic dye degradation and water splitting, it was recently found that nanocrystal superstructure based semiconductors exhibited improved spatial separation of photoexcited charge carriers and enhanced photocatalytic performance. Nevertheless, it remains unknown whether this strategy is applicable in gas-phase photocatalysis. Using porous indium oxide nanorods in catalyzing the reverse water-gas shift reaction as a model system, we demonstrate here that assembling semiconductor nanocrystals into superstructures can also promote gas-phase photocatalytic processes. Transient absorption studies prove that the improved activity is a result of prolonged photoexcited charge carrier lifetimes due to the charge transfer within the nanocrystal network comprising the nanorods. Our study reveals that the spatial charge separation within the nanocrystal networks could also benefit gas-phase photocatalysis and sheds light on the design principles of efficient nanocrystal superstructure based photocatalysts.

Effect of resveratrol on metabolic and cardiovascular function in male and female adult offspring exposed to prenatal hypoxia and a high-fat diet

Prenatal hypoxia, a common outcome of pregnancy complications, predisposes offspring to the development of metabolic and cardiovascular disorders in later life. We have previously observed that resveratrol improved cardiovascular and metabolic health in adult male rat offspring exposed to prenatal hypoxia and a postnatal high-fat (HF) diet; however, the effects of resveratrol in female rat offspring are not known. Our aim was to identify the mechanism(s) by which resveratrol may prevent metabolic and cardiac dysfunction in both male and female rat offspring exposed to prenatal hypoxia and a postnatal HF diet. Offspring that experienced normoxia or hypoxia in utero were fed a HF diet or a HF diet supplemented with resveratrol for 9 weeks following weaning. Body composition, metabolic function, in vivo cardiac function and ex vivo cardiac susceptibility to ischaemia-reperfusion (I/R) injury were assessed at 12 weeks of age. Prenatal hypoxia impaired metabolic function in male, but not female, rat offspring fed a HF diet and this was improved by resveratrol supplementation. Prenatal hypoxia also led to reduced recovery from cardiac I/R injury in male, and to a lesser extent in female, rat offspring fed a HF diet. Indices of cardiac oxidative stress after I/R were enhanced in both male and female rat offspring exposed to prenatal hypoxia. Resveratrol improved cardiac recovery from I/R injury and attenuated superoxide levels in both male and female rat offspring. In conclusion, prenatal hypoxia impaired metabolic and cardiac function in a sex-specific manner. Resveratrol supplementation may improve metabolic and cardiovascular health in adult male and female rat offspring exposed to prenatal hypoxia.

Aerobic exercise training reduces cardiac function in adult male offspring exposed to prenatal hypoxia

Intrauterine growth restriction (IUGR) has been associated with increased susceptibility to myocardial ischemia-reperfusion (I/R) injury. Exercise is an effective preventive intervention for cardiovascular diseases; however, it may be detrimental in conditions of compromised health. The aim of this study was to determine whether exercise training can improve cardiac performance after I/R injury in IUGR offspring. We used a hypoxia-induced IUGR model by exposing pregnant Sprague-Dawley rats to 21% oxygen (control) or hypoxic (11% oxygen; IUGR) conditions from gestational day 15 to 21. At 10 wk of age, offspring were randomized to a sedentary group or to a 6-wk exercise protocol. Transthoracic echocardiography assessments were performed after 6 wk. Twenty-four hours after the last bout of exercise, ex vivo cardiac function was determined using a working heart preparation. With exercise training, there was improved baseline cardiac performance in male control offspring but a reduced baseline cardiac performance in male IUGR exercised offspring ( P < 0.05). In male offspring, exercise decreased superoxide generation in control offspring, while in IUGR offspring, it had the polar opposite effect (interaction P ≤ 0.05). There was no effect of IUGR or exercise on cardiac function in female offspring. In conclusion, in male IUGR offspring, exercise may be a secondary stressor on cardiac function. A reduction in cardiac performance along with an increase in superoxide production in response to exercise was observed in this susceptible group.

Vascular effects of aerobic exercise training in rat adult offspring exposed to hypoxia-induced intrauterine growth restriction

KEY POINTS

Prenatal hypoxia, one of the most common consequences of complicated pregnancies, leads to intrauterine growth restriction (IUGR) and impairs later-life endothelium-dependent vascular function. Early interventions are needed to ultimately reduce later-life risk for cardiovascular disease. Aerobic exercise training has been shown to prevent cardiovascular diseases. Whether exercise can be used as an intervention to reverse the vascular phenotype of this susceptible population is unknown. Aerobic exercise training enhanced endothelium-derived hyperpolarization-mediated vasodilatation in gastrocnemius muscle arteries in male IUGR offspring, and did not improve nitric oxide-mediated vasodilatation in IUGR offspring. Understanding the mechanisms by which exercise impacts the cardiovascular system in a susceptible population and the consideration of sexual dimorphism is essential to define whether exercise could be used as a preventive strategy in this population.

ABSTRACT

Hypoxia in utero is a critical insult causing intrauterine growth restriction (IUGR). Adult offspring born with hypoxia-induced IUGR have impaired endothelium-dependent vascular function. We tested whether aerobic exercise improves IUGR-induced endothelial dysfunction. Pregnant Sprague-Dawley rats were exposed to control (21% oxygen) or hypoxic (11% oxygen) conditions from gestational day 15 to 21. Male and female offspring from normoxic and hypoxic (IUGR) pregnancies were randomized at 10 weeks of age to either an exercise-trained or sedentary group. Exercise-trained rats ran on a treadmill for 30 min at 20 m min(-1) , 5 deg gradient, 5 days week(-1) , for 6 weeks. Concentration-response curves to phenylephrine and methylcholine were performed in second order mesenteric and gastrocnemius muscle arteries, in the presence or absence of l-NAME (100 μm), MnTBAP (peroxynitrite scavenger; 10 μm), apamin (0.1 μm) and TRAM-34 (an intermediate-conductance calcium-activated potassium channel blocker; 10 μm), or indomethacin (5 μm). In adult male IUGR offspring, prenatal hypoxia had no effect on total vasodilator responses in either vascular bed. Aerobic exercise training in IUGR males, however, improved endothelium-derived hyperpolarization (EDH)-mediated vasodilatation in gastrocnemius muscle arteries. Female IUGR offspring had reduced NO-mediated vasodilatation in both vascular beds, along with decreased total vasodilator responses and increased prostaglandin-mediated vasoconstriction in gastrocnemius muscle arteries. In contrast to males, aerobic exercise training in IUGR female offspring had no effect on either vascular bed. Exercise may not prove to be a beneficial therapy for specific vascular pathways affected by prenatal hypoxia, particularly in female offspring.

The Rational Design of a Single-Component Photocatalyst for Gas-Phase CO2 Reduction Using Both UV and Visible Light

The solar-to-chemical energy conversion of greenhouse gas CO₂ into carbon-based fuels is a very important research challenge, with implications for both climate change and energy security. Herein, the key attributes of hydroxides and oxygen vacancies are experimentally identified in non-stoichiometric indium oxide nanoparticles, In₂O_3-x(OH)_y, that function in concert to reduce CO₂ to CO under simulated solar irradiation.

Adjuvants are Key Factors for the Development of Future Vaccines: Lessons from the Finlay Adjuvant Platform

The development of effective vaccines against neglected diseases, especially those associated with poverty and social deprivation, is urgently needed. Modern vaccine technologies and a better understanding of the immune response have provided scientists with the tools for rational and safer design of subunit vaccines. Often, however, subunit vaccines do not elicit strong immune responses, highlighting the need to incorporate better adjuvants; this step therefore becomes a key factor for vaccine development. In this review we outline some key features of modern vaccinology that are linked with the development of better adjuvants. In line with the increased desire to obtain novel adjuvants for future vaccines, the Finlay Adjuvant Platform offers a novel approach for the development of new and effective adjuvants. The Finlay Adjuvants (AFs), AFPL (proteoliposome), and AFCo (cochleate), were initially designed for parenteral and mucosal applications, and constitute potent adjuvants for the induction of Th1 responses against several antigens. This review summarizes the status of the Finlay technology in producing promising adjuvants for unsolved-vaccine diseases including mucosal approaches and therapeutic vaccines. Ideas related to adjuvant classification, adjuvant selection, and their possible influence on innate recognition via multiple toll-like receptors are also discussed.

Prenatal hypoxia is associated with long-term retinal dysfunction in rats

Background

Intra-uterine growth restriction (IUGR) has been associated with increased predisposition to age-related complications. We tested the hypothesis that rat offspring models of IUGR would exhibit exacerbated, age-related retinal dysfunction.

Methods

Female Sprague-Dawley rats (maintained at 11.5% O₂ from gestational day 15 to 21 to induce IUGR) and control offspring (maintained at 21% O₂ throughout pregnancy) had retinal function assessed at 2 months (young) and 14 months of age (aged) with electroretinogram (ERG) recordings. Retinal anatomy was assessed by immunofluorescence.

Results

Deficits in rod-driven retina function were observed in aged IUGR offspring, as evidenced by reduced amplitudes of dark-adapted mixed a-wave V_max (by 49.3%, P<0.01), b-wave V_max (by 42.1%, P<0.001) and dark-adapted peak oscillatory potentials (by 42.3%, P<0.01). In contrast to the rod-driven defects specific to aged IUGR offspring, light adapted ERG recordings revealed cone defects in young animals, that were stationary until old age. At 2 months, IUGR offspring had amplitude reductions for both b-wave (V_max by 46%, P<0.01) and peak oscillatory potential (V_max by 38%, P<0.05). Finally, defects in cone-driven responses were further confirmed by reduced maximal photopic flicker amplitudes at 2 (by 42%, P<0.001) and 14 months (by 34%, P = 0.06) and critical flicker fusion frequencies at 14 months (Control: 42±1 Hz, IUGR: 35±2 Hz, P<0.05). These functional changes were not paralleled by anatomical losses in IUGR offspring retinas.

Conclusions

These data support that the developing retina is sensitive to stressors, and that pathways governing cone- and rod-driven function differ in their susceptibilities. In the case of prenatal hypoxia, cone- and rod-driven dysfunction manifest at young and old ages, respectively. We must, therefore, take into account the specific impact that fetal programming might exert on age-related retinal dystrophies when considering related diagnoses and therapeutic applications.

Risk factors for preeclampsia in women from Colombia: a case-control study

BACKGROUND

Preeclampsia (PE) is a multi-causal disease characterized by the development of hypertension and proteinuria in the second half of pregnancy. Multiple risk factors have been associated with the development of PE. Moreover, it is known that these risk factors vary between populations from developed and developing countries. The aim of this study is to identify which risk factors are associated with the development of preeclampsia (PE) among Colombian women.

METHODS

A multi-centre case-control study was conducted between September 2006 and July 2009 in six Colombian cities. Cases included women with PE (n = 201); controls were aged-matched pregnant women (n = 201) without cardiovascular or endocrine diseases for a case-control ratio of 1:1. A complete medical chart, physical examination and biochemical analysis were completed before delivery. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of potential risk factors associated with PE.

RESULTS

The presence of factors present in the metabolic syndrome cluster such as body mass index >31 Kg/m2 (OR = 2.18; 1.14-4.14 95% CI), high-density lipoprotein <1.24 mmol/L (OR = 2.42; 1.53-3.84 95% CI), triglycerides >3.24 mmol/L (OR = 1.60; 1.04-2.48 95% CI) and glycemia >4.9 mmol/L (OR = 2.66; 1.47-4.81 95%CI) as well as being primigravidae (OR = 1.71; 1.07-2.73 95% CI) were associated with the development of PE, after adjusting for other variables.

CONCLUSION

Factors present in the cluster of metabolic syndrome and primigravidity were associated with a greater risk of PE among Colombian women. Understanding the role of this cluster of risk factors in the development of PE is of crucial importance to prevent PE and remains to be determined.

Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country

BACKGROUND

An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country.

METHODS

A multi-center case-control study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis.

RESULTS

Women with PE had lower concentrations of PIGF (p<0.0001) and higher concentrations of s-Eng (p=0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p=0.0004) and lower PIGF concentrations (p<0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p=0.005). Women with severe PE had higher concentrations of s-Eng (p=0.0008) and ox-LDL (p=0.01), and lower concentrations of PIGF (p<0.0001).

CONCLUSIONS

Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies.

Clinical trial to assess the effect of physical exercise on endothelial function and insulin resistance in pregnant women

Background

Preeclampsia (PE) is a common maternal disease that complicates 5 to 10% of pregnancies and remains as the major cause of maternal and neonatal mortality. Cost-effective interventions aimed at preventing the development of preeclampsia are urgently needed. However, the pathogenesis of PE is not well known. Multiple mechanisms such as oxidative stress, endothelial dysfunction and insulin resistance may contribute to its development. Regular aerobic exercise recovers endothelial function; improves insulin resistance and decreases oxidative stress. Therefore the purpose of this clinical trial is to determine the effect of regular aerobic exercise on endothelial function, on insulin resistance and on pregnancy outcome.

Methods and design

64 pregnant women will be included in a blind, randomized clinical trial, and parallel assignment. The exercise group will do regular aerobic physical exercise: walking (10 minutes), aerobic exercise (30 minutes), stretching (10 minutes) and relaxation exercise (10 minutes) in three sessions per week. Control group will do the activities of daily living (bathing, dressing, eating, and walking) without counselling from a physical therapist.

Trial registration

NCT00741312.

Gaslike model of social motility

We propose a model to represent the motility of social elements. The model is completely deterministic, possesses a small number of parameters, and exhibits a series of properties that are reminiscent of the behavior of communities in social-ecological competition; these are (i) similar individuals attract each other; (ii) individuals can form stable groups; (iii) a group of similar individuals breaks into subgroups if it reaches a critical size; (iv) interaction between groups can modify the distribution of the elements as a result of fusion, fission, or pursuit; (v) individuals can change their internal state by interaction with their neighbors. The simplicity of the model and its richness of emergent behaviors, such as, for example, pursuit between groups, make it a useful toy model to explore a diversity of situations by changing the rule by which the internal state of individuals is modified by the interactions with the environment.

Breast cancer incidence in Metro Manila and Rizal province: 1980-1992

Incidence was derived from published data from two population-based registries--the Philippine Cancer Society-Manila Cancer Registry, and the Department of Health-Rizal Cancer Registry, which covered 8.5 million residents (1990 census) of a 1674 sq. km area that comprises Metro Manila and Rizal province. 13 registry clerks actively sought new cancer cases in 96 hospitals and 30 Civil Registry offices. Both registries are members of the International Association of Cancer Registries and receive continuing professional assistance from the International Agency for Research on Cancer. For the period 1988-92, the combined age-standardized incidence rate (ASR) was 43.4 per 100,000 females, making breast cancer the second most common following lung cancer, and the highest among women. Breast cancer ASR in the Manila Registry was the highest in Asia with the exception of the Jews in Israel. Age-specific rates began to rise steeply starting at age-group 30-34 years and peaked at 196.6 for age-group 70-74 years. There were significant differences between cities and municipalities. The rates in the oldest and most urbanized cities were similar to some populations in Europe, South America, and Oceania, and were almost 3 times those of residents in rural municipalities whose new rates were similar to some Asian and African populations. The ASR has doubled in the 13-year period between 1980 and 1992. While the combined rates were still lower than those of Filipino migrants to Hawaii, San Francisco and Los Angeles, rates in some cities had approximated those observed in the migrant populations.

Cancer in Al-Qassim, Saudi Arabia: A retrospective study (1987-1995)

Regional differences in the pattern of cancer are obvious in Saudi Arabia. From January 1987 to December 1995, 1106 new cases of cancer (642 males, 464 females) were seen at the King Fahd Specialist Hospital in Buraidah, Al-Qassim. Overall, lymphomas, non-Hodgkin's and Hodgkin's disease combined were the most common malignancy seen (15.10%), followed by esophageal carcinoma (7.77%). Thyroid cancer was the most common malignancy among females (12.50%), followed by breast cancer (9.48%). The majority of the patients were in the younger age group (77% were <50 years of age). Among the hematological malignancies, acute lymphoblastic leukemia was the most frequent type (36.23%). Lymphomas were the most common malignancy (66.12%) seen in the pediatric age group (0-14 years), followed by leukemias and brain tumors. The pattern of cancer in Al-Qassim is generally similar to other regions of Saudi Arabia, with few regional variations. prominent among such variations is the high frequency of non-Hodgkin's lymphomas (NHL), esophageal and thyroid carcinomas.

Efficacy of fine-needle capillary biopsy in the assessment of patients with superficial lymphadenopathy

BACKGROUND

Fine-needle aspiration biopsy (FNAB) is an important tool for the cytologic assessment of patients with lymphadenopathy. The nonaspiration method (without the use of a syringe or a handle), or fine-needle capillary biopsy (FNCB), is becoming popular for its ease of learning and use. The authors compared the two techniques of fine-needle biopsy (with and without aspiration) for identifying the cause of superficial lymphadenopathy.

METHODS

Over a 2-year period 50 cytologic examinations were conducted in patients with superficial lymphadenopathy. Both procedures were performed at the same site; the order in which they were performed was determined randomly. Slides were fixed in a similar manner and examined by a cytotechnologist and pathologists blind to the procedure. Scores were tabulated and compared and diagnosis was confirmed by histologic examination.

RESULTS

The best and the average score for the yield of cellular material was higher with FNCB (P < 0.004). Cell preservation also was superior with FNCB (P = 0.00066). However, the failure rate was lower with FNAB (P = 0.7662).

CONCLUSIONS

FNCB of superficial lymph nodes yields adequate cellular material of superior quality, which may be advantageous in certain situations. However, the diagnostic yield does not appear to be significantly increased using this technique.