Childhood outcomes following preterm prelabor rupture of the membranes (PPROM): a population-based record linkage cohort study.

OBJECTIVE: The objective of this study is to determine child health, development and educational outcomes for infants born following preterm prelabor rupture of the membrane (PPROM). STUDY DESIGN: Population-based record linkage cohort study using data from NSW, Australia, 2001 to 2014. RESULTS: Of 121 822 births at 20 to 37 weeks, 18 799 (15%) followed PPROM, 56 406 (46%) followed spontaneous labor and 46 617 (38%) were planned. Compared with infants of a similar gestational age born following spontaneous labor or planned delivery, exposure to PPROM did not increase the risk of childhood mortality, childhood hospitalization, developmentally vulnerable at school entry, low reading or numeracy scores. Median latency ranged from 12 days (interquartile range 3 to 37 days) at 25 weeks to 1 day (0 to 2 days) at 36 weeks. Longer latency and more advanced gestational age at birth were associated with better outcomes. CONCLUSION: Infants born following PPROM are at no greater risk of adverse child health, development and education outcomes than those of similar gestational age born without PPROM.

Aging of collagen.

Current knowledge of the structure and the mechanism of formation of the covalent cross-links that fuse individual collagen molecules into a stable fiber is reviewed. Some of the mechanical properties of dermal connective tissue and the way in which these change with age can be correlated with the types of cross-link present in the tissue. Cross-links are routinely detected by treatment of a tissue sample with tritium-labeled borohydride and subsequent isolation and quantification of the cross-linked compound, which has been rendered radioactive by reaction with this reducing compound. After maturity, the number of detectable cross-links decreases even though the mechanical stability of the tissue increases. This anomaly is examined in the light of recent data suggesting that cross-links may be oxidized in vivo and thus become undetectable since they can no longer react with borohydride.

Excelsior: a retrospective view of collagen.

The current state of knowledge about the biosynthesis of the collagen molecule and the stabilization of fibers is reviewed. There have been a number of major breakthroughs during the past 25 years which will be described.

Increased hyaluronate and collagen biosynthesis and fibroblast estrogen receptors in macaque sex skin.

Sequential steroid administration of estradiol (E2) and progesterone (P) in spayed pigtailed macaques was used to precisely control the time course of sex skin swelling. After removal of the P implant, the sex skin swelled considerably and the water content of the sex skin increased manyfold over that of back skin. During the swelling phase, hyaluronate biosynthesis in sex skin increased dramatically compared with back skin of the same animals. Collagen synthesis also increased but to a lesser extent. Estrogen receptor levels were undetectable in back skin and very low in spayed animals that had been treated with both E2 and P. After removal of the P implant, both the level of estrogen receptor and the rate of hyaluronate biosynthesis increased. Immunocytochemistry with monoclonal antibodies against the estrogen receptor showed that the dermal fibroblast was the only cell type to stain positively for estrogen receptor. We conclude that the sex skin swelling that follows P withdrawal in pigtailed macaques bearing E2 implants is mediated by estrogen receptors in dermal fibroblasts and is a result of increased hyaluronic acid synthesis by these cells.

Biosynthesis of aortic collagen and glycosaminoglycan following immunological injury.

The effect of immunological injury upon the early in vivo changes in aortic connective tissue metabolism was studied. It was found that a single antigen (bovine serum albumin), when administered in multiple doses, activated collagen synthesis and increased the rate of lgycosaminoglycan synthesis in the arterial wall. The degree of stimulation of both connective tissue components was higher in animals receiving a higher dose of antigen.

Peptides from live yeast cell derivative stimulate wound healing.

Live yeast cell derivative is an alcoholic extract from yeast (Saccharomyces cerevisiae) that has previously been shown by three groups of workers to stimulate wound healing. Live yeast cell derivative is a complex mixture, and it was not known which of its many components was responsible for the biological activity. This study describes the separation and analysis of the major components, one of which is a peptide fraction that stimulates wound healing. The fraction consists of a mixture of peptides from 6000 to 17,000 d. It causes angiogenesis in a chick embryo yolk sac membrane assay and in a rabbit cornea assay, and it dramatically stimulates wound healing in the "Schilling/Hunt" wire mesh cylinder model at concentrations 25-fold lower than those required for the intact live yeast cell derivative.

Crosslink analysis as an indicator of collagen turnover in periodontal ligament from functioning and non-functioning teeth in the dog.

The assay of transiently-occurring reducible collagen crosslinks was used as an indication of collagen turnover in the periodontium from individual teeth. A tooth was removed on one side of the jaw to relieve the antagonist tooth of all occlusal forces. This did not influence the very high rate of collagen turnover observed in periodontal ligaments. It is concluded that this high rate of turnover is an intrinsic property of the tissue and is uninfluenced by occlusal or eruptive forces.

Age-related changes in reducible crosslinks of human dental pulp collagen.

Coronal pulp of human third molars from patients ranging in age from 16 to 40 yr was analysed for collagen, protein, calcium and reducible crosslink content. Dihydroxylsinonorleucine (DHLNL) was the major crosslink; it decreased with age. Hydroxylsinonorleucine (HLNL) and lysinonorleucine (LNL) appeared in insignificant amounts. Calcium content increased with age. Based on the premise that collagen synthesis is characterized by the presence of reducible crosslinks, the study showed that coronal pulp collagen synthesis decreases with age; this is accompanied by a decrease in collagen concentration in terms of dry weight and total protein between 16 and 30 hr of age.

Values, participatory democracy, and healthcare resource allocation: an application to a campus community.

As healthcare reform is debated, it is important that decision makers consider the values of all citizens, that is, what people find desirable or useful about healthcare services. Several states have used town meetings in an effort to determine their citizens' views on the values in the realm of healthcare. In this article, the authors describe a process in which individuals actively participate in an open discussion about issues surrounding allocation of healthcare resources in a university setting. Three different groups from the university community participated in separate, structured meetings to discuss their values concerning the allocation of scarce healthcare resources. Such meetings give participants opportunities to learn about their values and those of other persons in the community.