Secondary maternal-fetal consequences to electrical injury: A literature review.

Electrical injuries can occur in pregnant women but currently their incidence is not completely known. Notwithstanding, those represent clinical important events such maternal and fetal death, which can be avoided if properly managed. The objective of this paper is to describe the results of electrical injury (high and low voltage), in pregnant women in scientific reports. A systematic search was performed with keywords "electrical injuries", "lightning injuries", "lightning strike", "pregnant women" and "pregnancy", using the databases: MedLine, Scielo, Lilacs, Clinical key, Web of Science, Scopus, Springer, Science Direct, Embase and Medic Latina. Filters like language, time, design and availability of text were not used. Descriptive analyses were carried out for variables such as maternal-fetal consequences, voltage and type of exposure, based on the reports identified. From the total 74 cases identified, 71.1% survived after the exposition. From the total live-births 28.6% did not show any alteration, 7.1% presented maceration and burns, while 64.3% had another outcome. Electric injury leads to fetal compromise and death in exposed pregnant women, mainly in the first hours after the injury. However, monitoring should be continued for the risk of complications such as placenta abruption, oligohydramnios and fetal distress. It is possible an underreporting of these events.

Effects of centrifugation through three different discontinuous Percoll gradients on boar sperm function.

In this study, different combinations of 2-step, discontinuous gradient centrifugation were used, consisting of three different combinations of isotonic Percoll (45/60, 60/75 and 45/90%) that allowed us to select different sperm subpopulations from fertile and normozoospermic boars. Our objective in this study is to evaluate the effects of centrifugation through three different discontinuous Percoll gradients on sperm function parameters (motility, viability, morphology, acrosome status, chromatin condensation, DNA fragmentation, ROS generation, tyrosine phosphorylation and intracellular calcium concentration) and the sperm penetrating capacity in an IVF system. All the Percoll treatments evaluated increased the percentage of spermatozoa with normal morphology, the proportion of un-damaged DNA, normal chromatin condensation, motion parameters measured by CASA and the percentage of capacitated spermatozoa with tyrosine phosphorylated proteins compared to control group. Finally, the in vitro oocyte penetrating capacity of boar spermatozoa was significantly affected by Percoll centrifugation. All the Percoll treatments increased the penetration rates and mean number of sperm per penetrated oocyte. Despite the efficiency of all three of the sperm treatments tested in selecting spermatozoa with improved sperm parameters and capacity to penetrate oocytes in vitro, the optimum performance of this system was demonstrated after preselecting spermatozoa by centrifugation on a discontinuous 45/90 Percoll gradient. The P45/90 treatment leads to obtain a higher percentage of spermatozoa which develop properly the capacitation process as it was shown measuring tyrosine phosphorylation and intracellular calcium concentration.

Natriuretic peptide-induced relaxation of myometrium from the pregnant guinea pig is not mediated by guanylate cyclase activation.

We tested both relaxation and cGMP generation by atrial (ANP), brain (BNP), and C-type natriuretic peptide (CNP) in oxytocin-stimulated myometrium from near-term pregnant guinea pigs to investigate the ability and mechanism of natriuretic peptides to inhibit myometrial contractility. Myometrial strips were contracted by 10(-8) M oxytocin, and relaxation to the cumulative addition (10(-9)-10(-6) M) of the natriuretic peptides measured. Maximal relaxation to BNP was significantly greater than to ANP (52 versus 32% respectively; p < 0.05), whereas CNP failed to produce relaxation. However, the increase in cGMP produced by BNP (10(-7) M) was significantly less than that produced by ANP (10(-7) M) (4.5 versus 7.0 times basal; p < 0.05); CNP did not increase myometrial cGMP. Anantin, a competitive blocker of the guanylate cyclase A receptor, significantly reduced the increase in cGMP produced by ANP and BNP, but had no effect on relaxation induced by either peptide. Rp-8-Br-cGMP, an inhibitor of the cGMP-dependent protein kinase, did not alter BNP-induced relaxation. The atrial natriuretic peptide-fragment 4-23 amide, a natriuretic peptide clearance receptor agonist, failed to inhibit oxytocin-stimulated myometrial contraction. We conclude that natriuretic peptide induced relaxation of oxytocin-stimulated myometrium from the pregnant guinea pig is not mediated by either guanylate cyclase A or B activation, is independent of the cGMP pathway, and does not involve clearance receptor activation. Our results suggest that natriuretic peptide-induced relaxation of pregnant myometrium is mediated via a novel mechanism.

Chorion releases a factor that inhibits oxytocin-stimulated myometrial contractility in the pregnant guinea pig.

It was postulated that chorion releases a substance necessary for the maintenance of uterine quiescence during pregnancy. A decrease in the release of this substance at the end of the pregnancy would be necessary for normal myometrial activation. This hypothesis was tested by demonstrating the ability of chorion to inhibit oxytocin-stimulated myometrial contractility in vitro. Tissues were obtained from timed pregnant Duncan-Hartley guinea pigs either at pre-term or near-term gestation. Myometrial strips were placed in organ baths for isometric tension measurement and contractions stimulated by oxytocin (10(-8) mol/l). Fetal membranes or conditioned medium from chorion were added directly to the organ bath. Near-term chorion and chorion conditioned-medium decreased oxytocin-stimulated contractile activity to 39% and 49% respectively. Neither pre-term nor near-term amnion reduced oxytocin-stimulated myometrial contractile activity. Relaxation induced by pre-term chorion was greater than near-term chorion (23% and 41% of the oxytocin-induced basal level respectively; P < 0.05). Further, chorion-induced relaxation was independent of the gestational age of the myometrium. Human chorion from a term, not-in-labour woman also inhibited oxytocin-stimulated guinea pig myometrial contractility. It was concluded that the chorion releases a substance or substances that reduce oxytocin-stimulated myometrial contractility and may be involved in the maintenance of uterine quiescence during pregnancy.

Application of a functional genomics approach to identify differentially expressed genes in human myometrium during pregnancy and labour.

The molecular mechanisms regulating uterine relaxation and contraction during pregnancy are poorly understood. In the present study, we used for the first time a functional genomics approach applying gene array technology to identify novel candidate genes involved in the regulation of uterine quiescence and contractility during pregnancy. The purpose of this approach was to obtain a molecular snapshot of the expression profile of gene transcripts as a function of the time dependent process regulating myometrial quiescence. Using this approach, we found several genes whose expression in human myometrium was altered with the onset of labour. For example, the expression of insulin-like growth factor (IGF)-II, calgranulin A and B, and G-protein coupled receptor were decreased while the expression of IGF-binding proteins, Ca(2+)/CaM binding protein kinase C substrate, and angiotensin converting enzyme were increased in the labouring, compared with non-labouring, pregnant myometrium. The differentially-expressed genes include several genes whose roles in myometrial quiescence are yet to be understood, although they have been reported to regulate vascular smooth muscle tone. Our findings illustrate the advantage of a functional genomics approach over a single gene analysis in identifying a large number of novel and potentially important genes mediating uterine smooth muscle contractile activity.

Molecular mechanism of cGMP-mediated smooth muscle relaxation.

Contraction and relaxation of smooth muscle is a tightly regulated process involving numerous endogenous substances and their intracellular second messengers. We examine the key role of cyclic guanosine monophosphate (cGMP) in mediating smooth muscle relaxation. We briefly review the current art regarding cGMP generation and degradation, while focusing on the recent identification of the molecular mechanisms underlying cGMP-mediated smooth muscle relaxation. cGMP-induced SM relaxation is mediated mainly by cGMP-dependent protein kinase activation. It involves several molecular events culminating in a reduction in intracellular Ca(2+) concentration and a decrease in the sensitivity of the contractile system to Ca(2+). We propose that the cGMP-induced decrease in Ca(2+) sensitivity is a strategic way to achieve "active relaxation" of the smooth muscle. In summary, we present compelling evidence supporting a key role for cGMP as a mediator of smooth muscle relaxation in physiological and pharmacological settings.

First Report of Soybean Cyst Nematode (Heterodera glycines) on Soybean in Puerto Rico.

Soybean (Glycine max (L.) Merr.) winter nurseries have been planted in Puerto Rico at the USDA's Isabela farm for 25 consecutive years. The field has had one soybean crop each year, with a summer fallow period between winter nursery seasons. In February 1998, during an inspection of root nodulation, cysts were discovered on roots of an F2 population (Benning × Pureunkong). Microscopic examination of roots confirmed the presence of female nematodes of Heterodera glycines Ichinohe in various stages of development. No cysts were found when soil and roots were randomly sampled at various growth stages (R1 to R7) from other soybean fields in Puerto Rico (Isabela, Salinas, Lajas, and Juana Diaz). Also, no cysts were observed on roots of common bean (Phaseolus vulgaris) at growth stages R7 to R8 in a neighboring research field. However, cysts were observed on 35-day-old roots of soybean cv. Lee, common bean, and pigeon pea (Cajanas cajun) grown in the above infested soil. A race assay, slightly modified from standard protocols (3), determined that the infested soil contained race 2 of H. glycines. The infested field was rotated to sorghum during the summer of 1998 and then soybeans were planted in the 1998-1999 winter nursery. H. glycines occurs in at least 26 states of the U.S., and in Canada, Asia, and South America (1,2). References: (1) M. L. Mendes and D. W. Dickson. Plant Dis. 77:499, 1993. (2) R. D. Riggs and D. P. Schmitt. 1989. Soybean Cyst Nematode. Page 65 in: Compendium of Soybean Diseases. 3rd ed. J. B. Sinclair and P. A. Backman, eds. American Phytopathological Society, St. Paul, MN. (3) D. P. Schmitt and G. Shannon. Crop Sci. 32:275, 1992.

[The quality of antibiotic treatment in primary health care in the county of Osona (Barcelona)]. / Calidad del tratamiento antibiótico en la atención primaria de la comarca de Osona (Barcelona).

BACKGROUND: The evaluation and quality control of antibiotic prescription has become widespread in primary health care (PHC). Most of the studies performed have analyzed the quality of the drug and not the treatment. The aim of this study was to evaluate the quality of the antibiotic treatments of physicians in a concrete area and identify the most deficient aspects. METHODS: A prospective study was performed with the voluntary participation of general physicians and pediatricians of the PHC area of Osona (Barcelona, Spain) by the collection of a series of data of each antibiotic treatment carried out over 30 days. Consideration of each item to evaluate the quality of a given treatment was carried out by a nominal group. RESULTS: A total of 1,976 antibiotic treatments were administered by the 44 physicians participating in the study (68% of the target population). The aspect found to be most deficient was that 20% of the doctors prescribed an antibiotic in a diagnosis for which it was not susceptible and in 30% of the susceptible cases the choice of antibiotic was erroneous. The length of treatment was the aspect on posology showing the worst results (27% incorrect). The mean quality following the application of the scale elaborated by the nominal group was 72.6 (SD = 25.7) over a maximum of 100. Lower quality was observed in the pediatricians (p = 0.006), in the physicians working in the reformed network (p < 0.0001), in the prescriptions induced by another physician (p = 0.0001) and in those induced by the patient (p = 0.03). CONCLUSIONS: The number of antibiotics prescribed in non susceptible processes in primary health care should be reduced. Likewise, the choice of antibiotics prescribed should improve.