Obstetric conditions and the placental weight ratio.

INTRODUCTION: To elucidate how obstetric conditions are associated with atypical placental weight ratios (PWR)s in infants born: (a) ≥37 weeks gestation; (b) at ≥33 but <37 weeks gestation; and (c) <33 weeks gestation. METHODS: The study included all in-hospital singleton births in London, Ontario between June 1, 2006 and March 31, 2011. PWR was assessed as <10th or >90th percentile by gestational age-specific local population standards. Multivariable analysis was carried out using multinomial logistic regression with blockwise variable entry in order of temporality. RESULTS: Baseline factors and maternal obstetric conditions associated with PWR <10th percentile were: increasing maternal height, overweight and obese body mass indexes (BMI), large for gestational age infants, smoking, and gestational diabetes. Obstetric factors associated with PWR >90th percentile were: underweight, overweight and obese BMIs, smoking, preeclampsia, placenta previa, and placental abruption. In particular, indicators of hypoxia and altered placental function were generally associated with elevated PWR at all gestations. DISCUSSION: An association between obstetric conditions associated with fetal hypoxia and PWR ≥90th percentile was illustrated. CONCLUSIONS: The multivariable findings suggest that the PWR is similarly increased regardless of the etiology of the hypoxia.

A perinatal psychiatric service audit in New Zealand: patient characteristics and outcomes.

As part of a clinical audit, data were collected on all patients assessed and offered treatment by the Christchurch 'Mothers and Babies' Service between 1-7-98 and 30-6-2000. At assessment and discharge a comprehensive psychiatric interview and the Marcé Checklist were completed by clinicians and self-rating questionnaires were completed by the patient. Univariate analysis and logistic regression were performed on the variables collected. A significant proportion of women suffered from chronic recurrent psychiatric disorders. Pure 'postnatal depression' was uncommon. Thirty-eight percent of women were pregnant at assessment. Risk factors for poor maternal outcomes included history of chronic illness, high symptomatic scores at assessment, the presence of more than one Axis I diagnosis (excluding nicotine dependence) or an Axis II diagnosis, and poor interpersonal relationships. Perinatal psychiatric services need resources to treat women with a range of severe and chronic disorders and should pay attention to interpersonal issues in treatment.

The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls.

This study compares the social networks and perceived social support of 26 people with early psychosis and 26 people without a mental illness. The two groups were closely matched for age, sex, education level, and employment and relationship status, and had equivalent levels of depression. There were no differences between the two groups in the amount of perceived social support, number of family members, and number of participants with acquaintances. However, the psychosis group identified significantly smaller networks, t (50)=-2.34, P=0.024, with fewer friends, t (48)=-3.61, P=0.001, fewer people to turn to in a crisis, t (22.97)=-2.34, P=0.028, and a higher likelihood of service providers as members, chi(2)(1)=7.02, P=0.008. Given the important relationship between strong social networks and high levels of community functioning and tenure, future research needs to evaluate the type of social support most beneficial for people with early psychosis and to develop strategies to maintain and facilitate that support.

Stress and coping in early psychosis. Role of symptoms, self-efficacy, and social support in coping with stress.

BACKGROUND: Although coping with stress is important in early psychosis, little is known about how this population copes with the range of stressors they encounter in their daily life. This study aims to identify how people with early psychosis cope with a range of stressful situations and to identify what factors might influence their use of coping strategies. METHOD: Participants included a clinical group of 50 people with early psychosis and a non-clinical group of 22 people matched on age and gender. Data were obtained on symptomatology and social support for the clinical group, and stress and coping, and self-efficacy for all participants. RESULTS: The clinical group reported coping less well than the non-clinical group and they most commonly used emotion-focused coping. For the clinical group, effective coping correlated with less severe negative symptoms, greater perceived self-efficacy, social support and greater use of problem-focused coping. Self-efficacy and social support predicted increased frequency of the use of problem-focused coping. CONCLUSION: People with early psychosis who have greater feelings of self-efficacy and perceived social support, and the flexible use of problem-focused coping strategies, appear to be more likely to cope with day-to-day stressors.

Social skill as determinant of social networks and perceived social support in schizophrenia.

Factors influencing supportive social networks of people with schizophrenia are little understood. Data from 46 outpatients with schizophrenia were analysed using structural equation modelling to test plausible sets of inter-relationships between social skill, social networks, and social support. The data supported a tentative model about the causal relationships between variables. Paths showed that people with greater social skill had larger social networks, but did not necessarily perceive greater support from these networks. Negative symptoms accounted for some of the effect of social skill on social networks. Whereas groups of single-admission and multiple-admission participants did not differ in terms of social skill, social networks, or support, the age of the participants influenced their social skill and the size of their social networks. Younger participants had greater social skill and larger social networks. The results appear to suggest the importance of early intervention for young people with first-episode psychosis.

Sarcoptes scabiei in histopathologic sections of skin in human scabies.

The usual methods of diagnosis remove Sarcoptes scabiei from its habitat. Thus, one has no appreciation of the host-endoparasitic interaction, especially the pathologic response of the surrounding tissue and the means by which the mite survives and lives its life cycle in the skin. The biopsy specimen described in this article demonstrates the tissue reaction that can be correlated with clinical symptoms. It also clearly depicts the actual position, morphological features, and developmental cycle of the mite in the skin.

Secretion of Zeatin, Ribosylzeatin, and Ribosyl-1'' -Methylzeatin by Pseudomonas savastanoi: Plasmid-Coded Cytokinin Biosynthesis.

Cytokinin production by strains of the phytopathogenic bacterium Pseudomonas syringae pv savastanoi was measured by immunoaffinity chromatography of the culture medium on immobilized anti-cytokinin antibodies, followed by high performance liquid chromatography, radioimmunoassay and mass spectrometry. P. savastanoi strain PB213-2 secretes zeatin (80 nanograms per milliliter) and ribosylzeatin (80 nanograms per milliliter). Even higher levels of zeatin (400 nanograms per milliliter) are produced by the olive-specific strain EW1006, which also produces 180 nanograms per milliliter of the recently identified cytokinin, ribosyl-1'' -methylzeatin. The amounts secreted were approximately 1000 times greater than those secreted by Agrobacterium tumefaciens (DA Regier, RO Morris 1982 Biochem Biophys Res Commun 104: 1560-1566). Examination of cytokinin production by plasmid deletion mutants of PB213-2 and EW1006 indicated that cytokinin biosynthesis was specified, at least in part, by plasmid-borne genes. A fragment of the 105 kilobase pair plasmid from EW1006 was cloned into Escherichia coli where its expression resulted in dimethylallyl transferase activity and the secretion of zeatin.

Tinea capitis caused by Trichophyton tonsurans.

Children with tinea capitis caused by Trichophyton tonsurans often have a lifetime of association with the organism and, in spite of intermittent therapy, as adults pass the infection to successive generations. While most current treatment regimens are directed at treating the individual patient, our study supports the need to evaluate and possibly treat all family members and their home environment.

The cotton swab technic for the culture of dermatophyte infections--its efficacy and merit.

A set of three comparison studies under varying conditions was performed to determine the efficacy of a cotton swab technic for obtaining material for culture of dermatophyte infections. Matched fungal cultures, one by swab and one by scrape, on each of 110 subjects showed that there was no difference in the two methods. The merits of this culture technic are explored and the conclusion is drawn that the cotton swab is an efficient and reliable adjunct to the practice of dermatology.

Experimental leprosy with Mycobacterium lepraemurium in hairless mice (Mus musculus).

Forty-three homozygous albino hairless mice (Mus musculus) were inoculated intradermally on the head, back, sides and base of the tail with suspensions of lepromatous tissue containing numerous Mycobacterium lepraemurium (Hawaiian strain). Visible nodules were noted in all mice. These lepromatous nodules enlarged slowly and often merged with each other, covering up to two thirds of the dorsum. Several mice became blind during the course of the infection. All of the mice died or were killed 68 to 287 days following inoculation. Post-mortem examinations on representative mice showed, in addition to observed cutaneous lesions, generalized systemic murine leprosy. Smears and histological sections from nodules, skin, lymph nodes, spleen, liver, kidney, heart and lung were positive for acid-fast bacilli. The cysts in the skin (which are degenerated hair follicles filled with keratin-like material and which are one of the characteristics of hairless mice) contained scattered acid-fast bacilli, but no acid-fast globi. Ten mice with hair (M. musculus) which were used as controls did not reveal noticeable cutaneous nodules; however, all developed generalized visceral leprosy similar to that of the hairless M. musculus. Thus, hairless mice (with thymus) can be looked upon as a model for studying experimental cutaneous leprosy.

Induction of interferon by bacteria, protozoa, and viruses: defensive role.

Interferon is established as one of the natural defenses against virus infection. The evidence that interferon may serve a defensive role against certain protozoa is less complete and consists mainly of induction of interferon during protozoal infection, as well as interferon protection of mice against malarial infection. The evidence that interferon may function as a defense against certain bacterial infections is extended with data indicating that a wide variety of bacteria can induce interferon in the mouse and in cultured human peripheral lymphoid cells. This induction of interferon by bacteria and the ability of interferon under many conditions to activate neutrophils and macrophages raises the possibility that interferon may serve a defensive role against some bacteria.

Production of monoclonal antibodies specific for two distinct steric portions of the glycolipid ganglio-N-triosylceramide (asialo GM2).

Two hybrid cell lines were prepared by the fusion of mouse myeloma cells with the spleen cells of BALB/c mice that had been immunized with the glycolipid ganglio-N-triosylceramide (asialo GM2). The specificity of the monoclonal antibodies produced by these hybridomas, one an IgM and the other an IgG3, has been defined by hemagglutination inhibition, complement fixation, and lysis of glycolipid liposomes by antibody and complement. A major determinant recognized by the IgM antibody is the nonreducing terminal N-acetylgalactosamine including the C6 primary hydroxyl group, but excluding the C2-acetamide group of N-acetylgalactosamine, because oxidation with galactose oxidase produced a structure showing only minimal cross-reaction with the IgM but replacement of the N-acetyl group with an N-n-butyryl group produced a glycolipid that reacts with IgM antibody to the same extent as with the unmodified glycoplipd. A major determinant recognized by the IgG3 antibody is the terminal N-acetylgalactosamine including the C2-acetamido group, but excluding the C6 primary hydroxyl group of N-acetylgalactosamine, because replacement of the N-acetyl group with an N-n-butyryl group produced a glycolipid that did not react with the IgG3 antibody; in striking contrast the IgG3 antibody reacted with the C6-oxidized glycolipid as well as with the native glycolipid. Neither antibody reacted significantly with any other natural glycolipids tested including several that are structurally related to asialo GM2 such as ganglioside GM2, ganglio-N-tetraosylceramide (asialo GM1), or ceramide dihexoside. These results indicated that in addition to the fine structure specificity described above both antibodies recognize the nonreducing terminal GalNAc beta 1 leads to 4Gal structure. The strict antigenic specificity of these monoclonal anti-glycolipid antibodies indicates their great potential as specific probes for cell surface studies.

Evaluation of discordant laboratory data in patients with thyroid disorders.

The usefulness of the various tests of thyroid function has been evaluated over a three-year period. It is concluded that an uptake test and estimation of the serum protein-bound radioactive iodine (PB (131)I), supplemented as required by the protein-bound iodine (PBI), remain the best routine tests of thyroid function. Forty-five patients who gave discordant results on these tests over this period have been studied in detail and the value of other tests of thyroid function has been explored.