Risk factors for neonatal intensive care unit admission in Amman, Jordan.

A better understanding of risk factors for neonatal intensive care unit (NICU) admission can inform interventions to improve neonatal survival. This study aimed to describe a population of newborns admitted to a NICU in Amman, Jordan, and compare them with newborns discharged to home. Newborns born within 96 hours at Al-Bashir Hospital were enrolled from February 2010 to June 2011. Demographic and clinical data were collected for mothers and newborns. Of 5466 enrolled neonates, 373 (6.8%) were admitted to the NICU. The median gestational age of NICU infants was 36 weeks, median birth weight was 2.2 kg and 49.5% were delivered by non-elective caesarean section. Lower gestational age, lower birth weight, delivery by caesarean section and birth in the month of May were statistically significant risk factors for NICU admission. Risk factors for NICU admission were consistent with other populations worldwide; however, median gestational age and birth weight were higher than in developed countries.

Effect of pioglitazone on endothelial function in impaired glucose tolerance.

AIM: Flow-mediated dilation (FMD) is a surrogate marker of endothelial function, which has been proposed as a barometer of vascular health. Impaired microvascular response to reactive hyperaemia is thought to be the mechanism behind reduced shear stress and subsequently impaired FMD, which has been associated with cardiovascular events. This study aims to assess the effect of pioglitazone on the vasculature of patients with impaired glucose tolerance (IGT). MATERIALS AND METHODS: Forty IGT patients with no cardiovascular disease were compared with 24 healthy age- and sex-matched controls. Endothelial function was assessed using FMD of the brachial artery. Adiponectin (ADN) levels were measured and insulin sensitivity was calculated using homeostasis model assessment of insulin resistance (HOMA-IR). A randomised double-blind placebo-controlled trial of the IGT subjects was then performed, with subjects receiving either pioglitazone 30 mg od or matched placebo for 12 weeks before the measurements were repeated. RESULTS: The IGT subjects had a significantly impaired FMD compared with the controls (p < 0.001). Diastolic shear stress (DSS) was also significantly reduced in IGT (p = 0.04). High molecular weight (HMW) ADN was significantly lower in the IGT group than in controls (p = 0.03). On analysis of the IGT group after 12 weeks treatment, FMD was significantly increased in the pioglitazone group compared with placebo (p = 0.03) as was endothelium-independent dilation (EID) (p = 0.03). A significant increase in total ADN (p < 0.001), HMW ADN (p < 0.001) and HMW/total ratio (p = 0.001) occurred in the pioglitazone group compared with placebo. CONCLUSIONS: Pioglitazone improved endothelial function in IGT. Treatment with pioglitazone may reduce the risk of cardiovascular disease in this patient group.

Thiazolidinediones: effects on insulin resistance and the cardiovascular system.

Thiazolidinediones (TZDs) have been used for the treatment of hyperglycaemia in type 2 diabetes for the past 10 years. They may delay the development of type 2 diabetes in individuals at high risk of developing the condition, and have been shown to have potentially beneficial effects on cardiovascular risk factors. TZDs act as agonists of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) primarily in adipose tissue. PPAR-gamma receptor activation by TZDs improves insulin sensitivity by promoting fatty acid uptake into adipose tissue, increasing production of adiponectin and reducing levels of inflammatory mediators such as tumour necrosis factor-alpha (TNF-alpha), plasminogen activator inhibitor-1(PAI-1) and interleukin-6 (IL-6). Clinically, TZDs have been shown to reduce measures of atherosclerosis such as carotid intima-media thickness (CIMT). However, in spite of beneficial effects on markers of cardiovascular risk, TZDs have not been definitively shown to reduce cardiovascular events in patients, and the safety of rosiglitazone in this respect has recently been called into question. Dual PPAR-alpha/gamma agonists may offer superior treatment of insulin resistance and cardioprotection, but their safety has not yet been assured.

Enhanced endocytotic and transcytotic activity in the rat endometrium prior to embryo implantation.

BACKGROUND: Understanding the mechanisms by which fluid absorption and secretion occur in the endometrium is clinically important since conditions that deregulate this process reduce fertility. It has been suggested that luminal epithelial cells induce a crucial step in the process of embryo implantation called uterine closure via endocytotic fluid uptake. Uterine lumen closure is a key step in the process of embryo implantation and is absent in some infertile strains of mice. METHODS: To investigate the process of uterine closure a ferritin-based tracer, used as a marker of endocytosis, was injected into the uterine lumen on day 5 of pregnancy when closure occurs. RESULTS: Unexpectedly, luminal epithelial uptake of tracer was minimal on day 5 of pregnancy discrediting endocytosis as the induction method of uterine closure. In contrast, ferritin was found deep in the stromal portion of the endometrium in pre-pregnant animals. CONCLUSIONS: We have shown for the first time that uterine closure is not induced by luminal epithelial cell driven endocytosis. Another novel finding of this study was the passage of the tracer ferritin up to 15 cells deep into the endometrium suggesting an as yet unstudied mechanism by which information can be transported from the uterine lumen to the underlying stroma.

Aspiration emergencies.

Aspiration of foreign material into the lungs can represent a medical emergency requiring timely interventions to assure a favorable outcome. Establishment of a patent airway and maintenance of adequate oxygenation are the initial requirements for successful treatment of all types of aspiration emergencies. The nature of the aspirated material dictates further interventions and potential outcome.

Growth and development of cultured carrot cells and embryos under spaceflight conditions.

Morphogenetically competent proembryonic cells and well-developed somatic embryos of carrot at two levels of organization were exposed for 18.5 days to a hypogravity environment aboard the Soviet Biosatellite Cosmos 1129. It was confirmed that cultured totipotent cells of carrot can give rise to embryos with well-developed roots and minimally developed shoots. It was also shown that the space hypogravity environment could support the further growth of already-organized, later somatic embryonic stages and give rise to fully developed embryo-plantlets with roots and shoots.

Risk factors for neonatal intensive care unit admission in Amman, Jordan

A better understanding of risk factors for neonatal intensive care unit [NICU]admission can inform interventions to improve neonatal survival.This study aimed to describe a population of newborns admitted to a NICU in Amman Jordan,and compare them with newborns discharged to home.Newborns born within 96 hours at Al-Bashir Hospital were enrolled from February 2010 to June 2011.Demographic and clinical data were collected for mothers and newborns.Of 5466 enrolled neonates,373 [6.8%]were admitted to the NICU.The median gestational age of NICU infants was 36 weeks,median birth weight was 2.2 kg and 49.5% were delivered by non-elective caesarean section.Lower gestational age,lower birth weight,delivery by caesarean section and birth in the month of May were statistically significant risk factors for NICU admission.Risk factors for NICU admission were consistent with other populations worldwide;however,median gestational age and birth weight were higher than in developed countries

ان فهما افضل لعوامل خطر ادخال حديثي الولادة الى وحدة العنايه المركزة يمكن أن يرشد الى تدخلات تحسن من بقاء حديثي الولادة على قيد الحياه وقد هدفت هذه الدراسه الى بيان حاله مجموعة من حديثي الولادة الذين ادخلوا الى وحدة العنايه المركزة في عمان بالاردن ومقارنتهم مع حديثي الولادة خرجوا من المزل فتم تسجيل حديثي الولادة خلال 96 ساعه في مستشفي البشير استباقيا من شباط / فبراير 2010 حتى حزيران / يونيو 2011 وجمعت البيانات السكنيه والسريريه للامهات وحديثي الولادة من اصل 5466 حديثي ولادة مسجلين تم ادخال 373 (6.8%)الى وحدة العنايه المركزة وكان متوسط العمر الحملي للرضع الذين ادخلوا الى وحدة العنايه المركزة 36 اسبوعا ووسطى وزن الوليد 2.2 كجم وولد 49.5% منهم بعمليه قيصريه غير انتقائيه . انخفاض العمر الحملي وانخفاض وزن الوليد والولادة بعمليه قيصريه والولادة في شهر ايار/ مايو كانت عوامل خطر ذات دلالة احصائيه للادخال الى وحدة العناية المركزة . ان عوامل خطر ادخال حديثي الولادة الى وحدة العنايه المركزة كانت متماشيه مع شعوب اخري في العالم غير أن متوسط العمر الحملي ووزن حديثي الولادة كانا اعلى مما هما عليه في البلدان المتقدمة

Une meilleure comprehension des facteurs de risque pour ('admission en unite de soin intensifs neonatals permet d'orienter les interventions en vue d'arneliorer la survie des nouveau-nes.La presente etude avait pour objectif de decrire une population de nouveau-nes ad mis en unite de soins intensifs neonatals a Amman [Jordanie]et de mener une etude comparative avec des nouveau-nes rentres a domicile.Les nouveau-nes dont la naissance est survenue dans un laps de temps de 96 heures apres leur entree a Thopital Al-Bashir ont participe a I'etude entre fevrier 2010 et juin 2011.Des donnees demographiques et cliniques ont ete collectees pour les meres et les nouveau-nes.Sur 5 466 nouveau-nes,373 [6,8 %]ont ete admis en unite de soins intensifs neonatals.L'age gestationnel median des enfants admis dans I'unite etait de 36 semaines,le poids median a la naissance etait de 2,2 kg et 49,5 % d'entre eux etaient nes par cesarienne non elective.Un age gestationnel plus bas,un poids a la naissance plus faible,une naissance par cesarienne et la naissance au cours du mois de mai constituaient des facteurs de risque statistiquement significatifs pour une admission dans I'unite.Ces facteurs de risque co'mcidaient avec ceux d'autres populations dans le monde,mais Tage gestationnel et le poids a la naissance medians etaient plus eleves que dans les pays developpes

Pinopodes: a questionable role in endometrial receptivity.

BACKGROUND: A better understanding of endometrial receptivity is crucial to the creation and optimization of tests to assess the window of implantation in a clinical setting. Testing endometrial receptivity via scanning electron microscopy of endometrial samples reveals that pinopodes are a very good marker of endometrial receptivity in the rat. There is still disagreement in the literature as to their usefulness as a receptivity marker in both mice and humans. METHODS: Publications related to the discovery, study and usefulness of pinopodes as a marker of endometrial preparation for implantation in both rodents and humans were identified through MEDLINE and other bibliographic databases. RESULTS: There is substantial evidence that pinopodes are good markers of endometrial receptivity in the rat. Pinopodes are not useful in the mouse or human as consistent markers of endometrial receptivity for implantation. In the human, pinopodes have a prolonged (>5 days) presence in the luteal phase and fail to delineate the brief (24-48 h) window of receptivity. CONCLUSIONS: While there are many publications arising from one group supporting the use of pinopodes as a reliable marker of human endometrial receptivity, few independent groups have been able to confirm these results. The clinical usefulness of pinopodes to delineate a period of endometrial receptivity seems unlikely following recent findings that pinopodes are present throughout the luteal phase of the menstrual cycle.

Root-MUSIC analysis of nitric oxide-mediated changes in ophthalmic artery blood flow velocity waveforms.

Clinical and experimental studies indicate that structural and functional changes in the microvasculature can predate or accompany risk factors for cardiovascular disease at the earliest stages in the disease process. In the current work, both simulated and actual Doppler ultrasound maximum blood velocity waveform envelopes recorded from the ophthalmic artery were analysed using a root-MUSIC and least squares fitting approach to determine amplitude frequency spectra. Both amplitude and frequency components of noise contaminated simulated waveforms were reliably determined indicating the robustness of the technique. The technique was then used to compare the spectral content of the ophthalmic artery blood velocity waveforms of normal controls in three test states: at baseline, following administration of GTN, a nitric oxide donor, and following administration of L-Name, a nitric oxide inhibitor. Principal components derived from root-MUSIC analysis discriminated between waveforms in baseline and non-baseline test states (p<0.00001) and between GTN and non-GTN test states (p=0.0002).