Lentinus edodes Exposure before and after Fetus Implantation: Materno-Fetal Development in Rats with Gestational Diabetes Mellitus.

BACKGROUND: The presence of ß-glucans and phenolic compounds in Lentinus edodes suggests this mushroom can be used as a nutritional supplement. Two gestational conditions (before and after fetus implantation) were evaluated, and Lentinus edodes exposure was performed in diabetes mellitus rat model induced by streptozotocin in pre-clinical tests. METHODS: On the 20th day of pregnancy, cesarean sections were performed. Blood was collected for biochemical, hematologic parameters and oxidative stress biomarkers. Placenta and amniotic fluid were collected, and fetuses were analyzed through morphological evaluation. RESULTS: The mushroom did not reduce the severe hyperglycemia of the mother-concept but promoted an increase in maternal insulin levels; reduced the levels of alanine aminotransferase, and aspartate aminotransferase, triglyceride and total cholesterol; protected the animals from post-implantation losses. Liver damage induced by streptozotocin was reversed in experimental groups. CONCLUSIONS: Lentinus edodes mushroom has antioxidant properties that can minimize the damage caused by gestational diabetes mellitus.

Feeding and urine cotinine values in babies whose mothers smoke.

In Canada, 8% to 20% of infants are breast-fed by mothers who smoke. To determine whether breast-feeding increases infants' exposure to tobacco smoke products, urinary cotinine excretion was measured in 172 babies, 33 of whom were breast-fed. A milk sample was taken from the mothers who were breast-feeding, and cotinine was measured with gas chromatography. The breast-fed babies had a median cotinine to creatinine ratio of 433 ng/mg, whereas the bottle-fed babies' median was 200 ng/mg (P less than 10(-4)). Similar differences were observed after adjustment for the number of cigarettes smoked by the mother and by other smokers in the home in the previous 24 hours. The correlation coefficient between the number of cigarettes smoked by the mother and the breast milk cotinine concentration was significant (r = .69, P = 2 X 10(-4)). Moreover, urine cotinine values from the breast-fed babies increased with higher concentrations of cotinine in the mother's milk (r = .56, P = .02). These results provide evidence that breast-feeding increases exposure to tobacco smoke components in infants whose mothers smoke. This is yet another argument for strongly encouraging women who smoke to stop smoking during pregnancy and lactation.

The effect of leisure time physical activity on the risk of pre-eclampsia and gestational hypertension.

STUDY OBJECTIVE: To assess the relation between leisure time physical activity (LTPA) during the first 20 weeks of pregnancy and the risk of developing pre-eclampsia and gestational hypertension. DESIGN: Case-control study carried out over a 28 month period with retrospective data collection. SETTING: Six hospitals in Quebec City and four hospitals in Montreal. PARTICIPANTS: 172 women with pre-eclampsia, 254 with gestational diabetes, 505 controls. All were primiparous, with no history of high blood pressure before pregnancy (unless due to oral contraceptive use), or during the first 20 weeks of gestation. Cases were defined using recognised criteria, and 97% of those eligible agreed to be interviewed. Controls delivered in same hospital immediately after cases and had no more than one reading of elevated blood pressure during pregnancy; 96% of those eligible agreed to be interviewed. MEASUREMENTS AND MAIN RESULTS: Participants were interviewed in hospital a few days after delivery using a questionnaire. Information was collected on type, frequency and average duration of any LTPA performed regularly during the first 20 weeks of pregnancy, together with medical, obstetric and sociodemographic details. It was found that women who performed regular LTPA had a reduced risk of pre-eclampsia (adjusted RR 0.67, 95% CI 0.46-0.96) and gestational hypertension (aRR 0.75, 95% CI 0.54-1.05), and the relative risks decreased as the average time spent in LTPA increased (aRR for pre-eclampsia among women with low, moderate and high energy expenditure: 1.00, 0.77 and 0.57, p = 0.01). The same trend was present for gestational hypertension (1.00, 0.80 and 0.71, respectively, p = 0.08). CONCLUSIONS: Leisure time physical activity during the first half of pregnancy is likely to reduce the risk of pre-eclampsia and gestational hypertension.

[Carotid endarterectomy: preoperative medical history and long-term outcome of 82 patients]. / Endartériectomie carotidienne: histoire médicale préopératoire et devenir à long terme de 82 patients.

Using medical files, death certificates and an interview at home for the survivors, a long term retrospective follow-up study was done for 82 subjects operated for carotid stenosis. Causes of death, survival rates and medical history of survivors were studied. Subjects were classified in two preoperative risk categories according to their medical history prior to angiography: low risk (36 subjects) and medium risk (46 subjects). None of the subjects were lost during the follow-up period which varies from 81 to 105 months. At seven years, observed survival rate is significantly lower for the medium risk patients than for the low risk patients (43.0 +/- 8.6 versus 80.6 +/- 6.6; X2 M-H, p = 0.006). The difference between the survival rates is markedly noticeable after the fifth year of follow-up. Besides, the percentage of survivors who have developed cerebrovascular problems after the operation is significantly higher in the medium risk group than the low risk group (54.5% versus 25.0%, X2 p congruent to 0.04). Does this mean that the preoperative risk classification separates two different stages or two different forms of atherosclerosis?

Smoking during labour.

Smoking in hospitals is now forbidden. In several hospitals, however, women in labour are allowed to smoke in designated smoking areas. This study assesses whether smoking during labour increases the carboxyhaemoglobin concentrations in maternal and cord blood, taking into account the number of cigarettes smoked during pregnancy, duration of labour and parity. Women were questioned on their smoking behaviour shortly after delivery. A total of 295 mother-infant pairs were included in the study. Of the 94 (31.9%) smokers, 33 smoked during labour at home only and 34 during labour at the hospital. For newborns of smokers, the daily ration of cigarettes smoked by the mother during pregnancy and the number smoked during labour explained respectively 10.4% and 10.8% of the residual variance of carboxyhaemoglobin in cord blood. Smoking during labour significantly increases carboxyhaemoglobin levels. It should be prohibited in hospitals.

[Incidence of and indications for cesarean sections in the Quebec, Canada region 1973 and 1979]. / Fréquence et indications des césariennes dans la région de Québec, Canada, en 1973 et 1979.

This study describes the frequency of cesarean sections and their indications in eleven hospitals located in the Quebec City area, in 1973 and 1979. Information on cesarean sections was abstracted from hospital records. Birth certificates provide the information on all deliveries. From 1973 to 1979, the cesarean delivery rate increased from 7.9 to 13.6 per 100 deliveries. Repeat cesarean sections account for 40.4% of this increase, while primary cesarean sections for dystocia, breech presentation and fetal distress explain respectively 21.1%, 21.1% and 12.3% of the rise. Prolonged labour, prolonged rupture of membranes, general anesthesia and pre-term repeat cesarean section were observed less frequently among cesarean sections in 1979. Moreover, Apgar scores were higher in 1979 than in 1973.

[Smoking in pregnancy, birth weight and perinatal mortality]. / Cigarettes pendant la grossesse, poids de naissance et mortalité perinatale.

This study is based on a 10% random sample of medical certifications of birth in Quebec in 1970-71 and on additional information obtained from perinatal death certificates and birth registrations. Smoking in pregnancy significantly reduced the average birth weight after 35 weeks of gestation. It increased the risk of perinatal death by 24%. This increase was concentrated in the age groups under 25 and 35 +, in the parity groups 0 and 4 + and among women with less than 12 years of schooling. The proportion of mothers smoking during pregnancy was 43.2% and ranged as high as 62.2% among those under 20 with less than eight years of schooling. These depressingly high percentages imply that new educational approaches aimed particularly at high-risk groups should be developed and evaluated.

Twin pairs, smoking in pregnancy and perinatal mortality.

Twins born in the province of Quebec during the first six months of 1972 were ascertained by reviewing all live births and perinatal death certificates. A total of 852 twins, constituting 426 pairs, were included in the study. Smoking habits of the mother during pregnancy were recorded at the hospital of birth for 88.5% of the pairs. The risk of at least one perinatal death was significantly higher for twin pairs born to smoking mothers. The Mantel-Haenszel test statistic controlling for sex of pairs, parity (0,1+), maternal age (< 25,25+ years) and years of schooling was 4.224 (p = 0.04). The standardized risk ratio for smoking versus nonsmoking mothers that a pair will have at least one death was 1.77 (95% confidence limits: 1.03-3.04). As expected, the relative risk of perinatal death associated with smoking appears to be higher for twins than for singletons.

Survival in breast cancer: study of 283 patients.

Records of 283 women with breast cancer diagnosed from 1965 through 1973 at l'Hôpital du Saint-Sacrement were studied for survival at 3 and 5 years. These were all patients who had not previously received cancer-directed treatment. Life-table methods based on full intervals only were used to analyze survival. Adjustment for deaths from other causes was provided by computing the expected and relative survival rates. The 5-year relative survival rates (%) were 60.2+/-4.1 for the total group of 283 patients, 87.9+/-4.5 for the 142 with localized disease and 44.9+/-59 for the 118 with regional spread. Of the patients with disease that was either localized or regional, 84% underwent total mastectomy. The age of patients at entry did not differ from that of cases reported to the Quebec Tumour Registry. The significant increase over time in the proportion of patients with localized disease would be expected to reduce the Quebec death rate from breast cancer in future if the better survival of these patients is not simply a function of earlier diagnosis.

Frequency of Down syndrome in livebirths by single-year maternal age interval: results of a Massachusetts study.

An analysis of rates of intra-state Down syndrome livebirths to Massachusetts residents by single-year maternal age interval in 1958-1965 inclusive was carried out. A gradual increase of rate of the Down syndrome occurred from age 20 to about age 31, and a steeper increase thereafter. Different regression equations were derived in the 20-31 and the 33-45 age group. The regression equations were ln y = 0.04515 x -1.45759 for those age 20-31 and ln y = 0.24302x-7.57870, for those age 33-45, where y = rate per 1,000 and x = maternal age. The regression-derived rates are slightly lower than those reported in similar analyses of data from Sweden and New York State, but they are not markedly discrepant.

Calcium intake from dairy products and supplements and the risks of preeclampsia and gestational hypertension.

This case-control study assessed the relation of calcium intake in the first 20 weeks of pregnancy to the risks of preeclampsia and gestational hypertension. All subjects (172 women with preeclampsia, 251 women with gestational hypertension, and 505 controls) were primiparae who delivered in Quebec City or Montreal, Quebec, Canada, between April 1984 and December 1986. Dietary calcium intake was not associated with preeclampsia. For gestational hypertension, adjusted odds ratios in successive quartiles gradually decreased from 1.00 in the lowest quartile to 0.81, 0.66, and 0.60 in the highest quartile. These results provide additional support for the view that calcium intake during pregnancy may be inversely related to the risk of gestational hypertension.

Place and time aspects of the occurrence of Down's syndrome.

Prevalence rates at birth for Down's syndrome were compared for Massachusetts communities of different population densities. Overall, there was a small positive association between the rate of Down's syndrome and population density, entirely attributable to a strong association for the children of older mothers. An analysis for space and time clustering of births of 2469 children born in Massachusetts with Down's syndrome revealed no aggregation of cases, except for a slight seasonal peak in the summer.

The effect of cigarette smoking on the risk of preeclampsia and gestational hypertension.

This case-control study assessed the relation of cigarette smoking during pregnancy to the risk of preeclampsia and gestational hypertension. All subjects were primiparous women without a history of high blood pressure who gave birth in Quebec City or Montreal, Canada, hospitals between 1984 and 1986. Cases (172 women with preeclampsia and 251 with gestational hypertension) and 505 controls were interviewed at the hospital after delivery. Adjusted relative risks were estimated by polychotomous logistic regression. Compared with women who had never smoked, women who were smokers at the onset of pregnancy had a reduced risk of preeclampsia (relative risk = 0.51, 95% confidence interval 0.34-0.77). Relative risks of preeclampsia decreased with increases in the number of cigarettes smoked daily at the onset of pregnancy: Relative risks among smokers of less than 11, 11-20, and more than 20 cigarettes per day were 0.79, 0.56, and 0.38, respectively (test for trend: p = 0.0002). The protective effect of smoking on preeclampsia was stronger for women who continued to smoke after 20 weeks of pregnancy. While smoking tended to reduce the risk of gestational hypertension, this effect was less evident than that for preeclampsia. Relative risks varied little with severity of disease as based on gestational age at the onset of hypertension, maximal blood pressure and, for preeclampsia, amount of proteinuria. The reduction in mean birth weight attributable to smoking during pregnancy was similar among cases and controls. Nicotine inhibition of thromboxane A2 production might explain the decreased risk of pregnancy-induced hypertension among smokers. Despite these findings, the harmful consequences of smoking on pregnancy outcome outweigh its protective effect against pregnancy-induced hypertension.

Quality of life of 50 carotid endarterectomy survivors: a long-term follow-up study.

The quality of life of 50 subjects who underwent carotid endarterectomy was investigated in a follow-up study varying from 81 to 105 months. Subjects were retrospectively classified in either low or medium preoperative risk categories. Risk was determined from the previous medical history and the findings of the carotid angiography. Quality of life was estimated from the functional level and such psychosocial factors as work, leisure, and finances during the follow-up period. All subjects had minimal dysfunction in ADL and cognition. Medium risk subjects, however, had marked dysfunction in home and outside activities and social interaction. Fifty percent of the working subjects were forced to take an early retirement. Quality of life seems more affected by cardiovascular problems in the 22 medium risk patients and by neurologic problems in the 28 low risk patients. This study suggests the importance of long-term rehabilitation goals to preserve the quality of life.

History of migraine and risk of pregnancy-induced hypertension.

This analysis assesses the relation between a history of migraine and the risk of preeclampsia or gestational hypertension. Cases (172 women with preeclampsia and 254 with gestational hypertension) and controls (505) were primiparae with no history of hypertension before pregnancy. Information on migraine attacks in the year before pregnancy was obtained after delivery. Migraine was reported by 16% of preeclamptic women, 12% of women with gestational hypertension, and 8% of the controls. Adjusted odds ratios (95% confidence interval) of preeclampsia and gestational hypertension were 2.44 (1.42-4.20) and 1.70 (1.02-2.85), respectively. We conclude that women who have a recent history of migraine may be at higher risk of pregnancy-induced hypertension.

Survival in colorectal cancer.

The authors studied the hospital records of 258 patients with colorectal cancer diagnosed between 1965 and 1974 at l'Hôpital du Saint-Sacrement, Quebec and computed expected and relative survival rates to adjust for deaths from other causes. Life-table methods based on full intervals only were used to analyse survival. The patients (138 men and 120 women) ranged in age from 24 to 96 years (mean, 64.9 +/- 12.7 years). The 5-year relative survival rate expressed as a percentage was 48.6 +/- 4.7 for the total group and 64.1 +/- 5.6 for patients in stages A, B and C of Dukes' classification. The overall operative mortality rate of 2.7% compared favourably with that reported elsewhere. Among patients with cancer of the sigmoid colon or rectum (the most readily detectable), the diagnosis was made at stage A in one out of nine and at stage D in approximately one out of four. Despite the introduction of universal medical insurance in Quebec in 1970, there has been no significant trend towards earlier diagnosis.

Recent time-trends of age-specific death rates for breast cancer: Quebec and other provinces, 1965 through 1974.

For the 10-year period 1965 through 1974 the age-specific death rates for cancer of the breast decreased among middle-aged women, especially at ages 40 to 49 years, in Quebec, the Maritimes and the Prairies but not in Ontario or British Columbia. In women under 35 years of age the mortality generally increased, while in women aged 60 to 64 years there was little change except in the Prairies, where the rate increased. It seems probable that the trends reflect changes in incidence rather than in case-fatality. Some, but not all, of the pattern could be explained by changes in fertility over the past 50 years.

Beware of breast fibroadenomas in middle-aged women.

On first examination of 8512 Quebec area women from 40 to 59 years of age who participated in the National Study of Breast Cancer Screening, the prevalence of fibroadenoma was 8.3 per 1000. In two women, a carcinoma was discovered within their fibroadenoma--intraductal carcinoma in one and an infiltrating ductal carcinoma in the other. Clinical and histopathologic findings are described and the prognosis and treatment discussed. The peak age of women at the time of diagnosis of a fibroadenoma is in their twenties while for those with a fibroadenoma containing a carcinoma, it is in the forties. For patients under 25 years, excision can be postponed for a few months since spontaneous regression may occur and the risk of breast cancer is small at that age. For older women, treatment should not be delayed.