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PubMed2005

Hydroxyapatite-coated metals: interfacial reactions during sintering.

Electrophoretic deposition (EPD) is a low cost flexible process for producing HA coatings on metal implants. Its main limitation is that it requires heating the coated implant in order to densify the HA. HA typically sinters at a temperature below 1150 degrees C, but metal implants are degraded above 1000 degrees C. Further, the metal induces the decomposition of the HA coating upon sintering. Recent developments have enabled EPD of metathesis-synthesised uncalcined HA which sinters at approximately 1000 degrees C. The effects of temperature on HA-coated Ti, Ti6Al4V, and 316L stainless steel were investigated for dual coatings of metathesis HA sintered at 1000 degrees C. The use of dual HA coatings (coat, sinter, coat, sinter) enabled decomposition to be confined to the "undercoat" (HA layer 1), with the surface coating decomposition free. The tensile strength of the three metals was not significantly affected by the high sintering temperatures (925 degrees C < T < 1000 degrees C). XRD/SEM/EDS analyses of the interfacial zones revealed that 316L had a negligible HA:metal interfacial zone (approximately 1 microm) while HA:Ti and HA:Ti6Al4V had large interfacial zones (>10 microm) comprising a TiO2 oxidation zone and a CaTiO2 reaction zone.

Alloys↗
PubMed2007

Complex emotions, complex problems: understanding the experiences of perinatal depression among new mothers in urban Indonesia.

In this article, we explore how Javanese women identify and speak of symptoms of depression in late pregnancy and early postpartum and describe their subjective accounts of mood disorders. The study, conducted in the East Java region of Indonesia in 2000, involved in-depth interviews with a subgroup of women (N = 41) who scored above the cutoff score of 12/13 on the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy, at six weeks postpartum, or on both occasions. This sample was taken from a larger cohort study (N cohort = 488) researching the sociocultural factors that contribute to women's emotional well-being in early motherhood. The women used a variety of Indonesian and Javanese terms to explain their emotional states during pregnancy and in early postpartum, some of which coincided with the feelings described on the EPDS and others of which did not. Women attributed their mood variations to multiple causes including: premarital pregnancy, chronic illness in the family, marital problems, lack of support from partners or family networks, their husband's unemployment, and insufficient family income due to giving up their own paid work. We argue for the importance of understanding the context of childbearing in order to interpret the meaning of depression within complex social, cultural, and economic contexts.

Adolescent↗
PubMed1983

Decrease of angiotensin sensitivity after bed rest and strongly sodium-restricted diet in pregnancy.

Angiotensin II (A-II) sensitivity was determined in 23 nonmedicated nulliparas in the third trimester of pregnancy, before and after a 7- to 10-day period of bed rest and a strongly sodium-restricted diet (maximal 20 mmol Na+/24 hr). Seventeen nulliparous women had pregnancy-induced hypertension (PIH). The effective pressor dose (EPD), that is the minimal amount of A-II necessary for a 20 mm Hg elevation of the diastolic blood pressure, rose from a mean of 11.0 +/- 5.0 to 17.9 +/- 5.7 ng/kg/min. This is an increase of the mean of 63%. Six women were normotensive during the course of the pregnancy. They showed an increase of EPD from 12.6 +/- 4.9 to 28.3 +/- 10.9 ng/kg/min after sodium restriction and bed rest. This is a mean increase of 124%. It is concluded from this study that sodium not only is important in volume regulation but also seems to play a role in vessel wall reactivity. This effect of sodium on vascular reactivity could be the explanation for the favorable effect of a strongly sodium-restricted diet in lowering the incidence of eclampsia in women with PIH.

Adult↗
PubMed1987

Radioenzymatic determination of phenylpropanolamine in plasma.

We modified a norepinephrine radioenzymatic method (C. R. Lake, M. G. Ziegler, and I. J. Kopin, 1976, Life Sci. 18, 1315-1326) for determination of plasma phenylpropanolamine (PPA) concentrations. PPA is converted to N[methyl-3H]ephedrine ([3H]EPD) by the enzyme phenylethanolamine N-methyltransferase (PNMT) and S-[methyl-3H]adenosyl-L-methionine ([3H]AdoMet). The product, [3H]EPD, is isolated from unreacted [3H]AdoMet and labeled side products by an organic extraction and a TLC procedure. In addition, a preincubation organic extraction procedure is included to remove inhibitors of PNMT from plasma and to concentrate the sample for enhanced enzymatic conversion. In order to accurately quantitate PPA across the wide range of possible concentrations, the assay is conducted at two plasma volumes. PPA concentrations between 0.3 and 50 micrograms/liter can be detected with 1 ml of plasma, while concentrations between 4 and 1500 micrograms/liter can be detected with 0.1 ml of plasma. The intra-assay coefficients of variation (CVs) are 9.3 and 5.7% at 0.5 and 1500 micrograms/liter, respectively, while the mean interassay CV is 13.8%.

Humans↗
PubMed1987

Evidence for epinephrine-induced depolarization in neurons of bullfrog sympathetic ganglia.

The response to epinephrine (EP) was determined for neurons in bullfrog sympathetic ganglia by intracellular and voltage-clamp recording techniques. EP (5 microM-1 mM) produced a concentration-dependent depolarization mediated through beta-adrenoceptors. The EP-induced depolarization (EPD) was associated with a decrease in the membrane conductance. The EP-induced current (EP1) was decreased at hyperpolarizing potential levels and nullified at -70 mV. No reversal of the EPI polarity was seen. It is concluded that the EPD is generated by the suppression of a voltage-dependent gK, probably the M-channel.

Adrenergic alpha-Antagonists↗
PubMed1994

Screening women for high risk of postnatal depression.

A ten-item screening questionnaire was constructed from previous reports on risk factors for postnatal depression, and its ability to predict antenatally the development of postnatal depression was tested. Women attending an antenatal clinic at 36 wk gestation completed the questionnaire and, at 8 wk postpartum, were assessed for the presence of depression using the Edinburgh Postnatal Depression Scale (EPDS). Although antenatal questionnaire scores correlated significantly with postnatal EPDS scores, this was largely because the questionnaire was able to identify correctly those who would not become depressed. Neither the questionnaire as a whole, nor groups of items, was able to discriminate well between women who later did or did not become depressed. However, women who reported previous or current treatment for depression were at a threefold greater risk of becoming or remaining depressed postnatally. Possible reasons for the negative results are discussed, including the heterogeneity of depression occurring in the postnatal period.

Adult↗
PubMed2004

Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort.

OBJECTIVE: Studies have suggested that women with pregnancy anxiety may be at greater risk of postnatal depression (PND). However, due to the high comorbidity between anxiety and depressive disorders, this finding may be confounded by the association between prenatal depression and postnatal depression. The aim of the present prospective study was to assess whether anxiety disorder (AD) during pregnancy is an independent predictor of intensity of postnatal depressive symptoms. METHOD: The MATQUID cohort survey was conducted on pregnant women (n = 497) attending a state maternity hospital. Psychiatric status during pregnancy was assessed during the third trimester using a structured diagnostic interview. Intense postnatal depressive symptoms at 6 weeks post-partum were defined by a score >12 on the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: Nearly one out of four women (24.1%) presented with at least one pregnancy AD, and 29 (5.8%) presented with a score >12 on the EPDS. After adjustment for presence of major depression during pregnancy and other confounding factors, women with pregnancy AD were nearly three times more likely to present with intense postnatal depressive symptoms (OR = 2.7, 95%CI 1.1-6.3, P = 0.03). CONCLUSION: Promoting the recognition and management of AD in pregnant women may be of interest for the prevention of postnatal depression.

Anxiety Disorders↗
PubMedDate not supplied

Risk factors for early postpartum depressive symptoms.

OBJECTIVE: Postpartum depressive disorders are common and symptoms may appear as early as the first 2 weeks postpartum. Data regarding hormone-related risk factors for depressive symptoms occurring in the very early postpartum period are scarce and may be of importance in identifying serious postpartum illness. We examined the association between the reported history of psychiatric symptoms of possible hormonal etiology and very early postpartum depressive symptoms. METHODS: All women (n= 1,800) in a general hospital maternity ward were assessed during the first 3 days after parturition for potential risk factors for postpartum depressive disorders by a self-reported questionnaire and for present mood symptoms (Edinburgh Postnatal Depression Scale, EPDS). The associations between potential risk factors and postpartum depressive symptoms were analysed. RESULTS: The incidence of women with an EPDS >or=10 was 6.8% (88/1,286). Significant risk factors for early postpartum depressive symptoms were a history of mental illness including past postpartum depression (PPD), premenstrual dysphoric disorder (PMDD), and mood symptoms during the third trimester. CONCLUSION: In accordance with other studies, a history of depression was found to be a risk factor for early postpartum mood symptoms. An association was also found between some risk factors of possible hormone-related etiology such as PMDD and third trimester mood symptoms and early postpartum mood symptoms. As such, early postpartum symptoms may indicate vulnerability to subsequent PPD; it may be of importance to assess these risk factors and mood immediately after parturition. A prospective study is needed to determine which of these risk factors is associated with progression to PPD and which resolves as the blues.

Adult↗
PubMed2004

The association between depressive symptoms and social support in Taiwanese women during the month.

The purpose of the study was to explore the association between depressive symptoms and social support in Taiwanese women doing the month. A correlational survey design using the Postpartum Social Support Questionnaire (PSSQ) and the Edinburgh Postnatal Depression Scale (EPDS) to measure social support and postnatal depressive symptomatology was employed. Two hundred and forty postpartum women receiving care in two teaching hospitals in Taipei, Taiwan, aged between 20 and 35, with no peri-natal complications or previous psychiatric history, experiencing a normal spontaneous delivery of one full term healthy baby, were selected. Each was mailed the PSSQ and the EPDS as well as a short, semi-structured self-report questionnaire requesting demographic details and subjective data relating to the experience of doing the month and depressive symptoms during the fourth week following birth. One hundred and eighty six women (78%) returned questionnaires. Taiwanese postpartum women were less depressed when they stayed in their parents' home and had their own mothers take care of them. It was found that the greater the level of postpartum social support received by the women doing the month, the lower the risk of postnatal depressive symptoms experienced. Almost a quarter (24%) of the variance of the symptoms was attributed to dissatisfaction with parents' instrumental support and unwanted emotional support from parents-in-law. It is concluded that the ritual of doing the month provides valuable social support and may help to prevent postnatal depression in Taiwanese women.

Adaptation, Psychological↗
PubMed2006

Examining the relationship between antenatal anxiety and postnatal depression.

BACKGROUND: Antenatal anxiety has received increased attention with regards to both its impact on infant outcomes and as a risk factor for postnatal depression. The measurement of anxiety in the perinatal setting, however, has proven to be challenging. The aims of the present study are to: determine whether antenatal anxiety as measured by the Brief Measure of Worry Severity (BMWS) is a significant predictor of postnatal depression (PND); examine the psychometric properties of a new measure of anxiety - the BMWS - in an antenatal sample; and examine the comparative capacity of the BMWS to the Speilberger State Trait Anxiety Inventory (STAI) in predicting PND. METHOD: A sample of 748 women completed the BMWS and STAI during the third trimester of pregnancy and returned the Edinburgh Postnatal Depression Scale (EPDS) at 8 weeks postpartum. RESULTS: Women with high antenatal anxiety on the BMWS were 2.6 times more likely to have probable PND than those with low scores, even after controlling for confounding factors, including level of antenatal depression on the EPDS. In contrast, the STAI was no longer a significant predictor of PND after controlling for these variables. The BMWS has good construct validity, with scores on this scale correlating strongly with scores on other measures of anxiety, depression and perinatal risk. LIMITATIONS: When compared to those who participated in the follow-up at 8 weeks postnatally, those who did not participate appeared to be at greater risk of developing PND, raising the possibility of attrition bias within this sample. CONCLUSIONS: The findings from this study suggest that the BMWS has utility in measuring antenatal anxiety in both clinical and research settings and that antenatal anxiety is an important precursor of PND.

Adult↗
PubMed2004

Assessment of AWT systems in the metro Atlanta area.

A study was conducted to evaluate the performance of six advanced wastewater treatment facilities using biological nutrient removal processes as the primary mechanism for removing carbon, nitrogen, and phosphorus from domestic wastewater. One year of operating data was obtained from monthly operating reports provided by the Georgia Environmental Protection Division (EPD) in Atlanta. Additional information about facility operations and the types of chemicals used was gathered through review of EPD files and interviews with plant personnel. Data evaluated were: influent and effluent five-day Biochemical Oxygen Demand (BOD(5)); influent and effluent total suspended solids (TSS); influent Total Kjeldahl Nitrogen and effluent Total Nitrogen; and influent and effluent Total Phosphorus (TP). Although varying from plant to plant, effluent requirements for BOD(5), TSS, ammonia, and TP were met. Chemicals utilized, design capacity, and monthly effluent concentrations are presented in this study.

Ammonia↗
PubMed2006

Current status of carotid artery stenting.

This Clinical Update summarizes the results of larger case series, industry-sponsored registries, and randomized trials of carotid artery stenting (CAS). In >20 case series that studied >24,000 patients undergoing CAS, 51% of patients were symptomatic, most procedures (97%) resulted in successful stent deployment, and 30-day stroke rates varied from 1% to 8%, with a trend toward lower rates as experience and embolic protection device (EPD) use increased. In 12 industry-sponsored registries (none were published in peer-reviewed journals), 30-day stroke rates varied from 2% to 7%, and 30-day combined adverse events, including stroke, death, and myocardial infarction, were 3% to 9%. More than 12 randomized trials comparing CAS and carotid endarterectomy (CEA) have been initiated since 1998. Results have varied over time, depending on the population studied and the technology used. However, the largest and most recent results of the completed SAPPHIRE trial in high-risk patients undergoing CAS with the use of EPDs demonstrated that CAS is at least not inferior to CEA, with a 1-year combined adverse event rate of 12% for CAS and 20% for CEA (P = .05). Other ongoing trials will address not only whether CAS could be superior to CEA in high-risk patients but also, more importantly, whether CAS is beneficial in other subgroups, such as low-risk and asymptomatic patients.

Angioplasty↗
PubMed2006

Do device characteristics impact outcome in carotid artery stenting?

OBJECTIVES: The study was conducted to identify patient and procedural parameters that negatively impact the 30-day rates for stroke, death and transient ischemic attack (TIA) after carotid artery stenting (CAS) and that might be modified or further studied in future efforts to improve CAS. METHODS: This was a retrospective investigation of a dual-center CAS database of 701 consecutive CAS patients (414 men; mean age, 72.4 +/- 8.4). A subset of patient-related, lesion-related, or procedure-related variables (age >or=80, left sided lesion, symptomatic, nicotine abuse, hypertension, diabetes mellitus, other peripheral vascular disease, hypercholesterolemia, embolic protection devices usage, predilation, ulcerated lesion, echolucent plaque, restenosis after surgery) were analyzed for association with occurrence of stroke, death, or TIA <or=30 days after CAS. The odds ratio (OR) and 95% confidence interval (CI) and P value were calculated for each variable to predict adverse outcome. RESULTS: The overall combined rate of stroke, death, and TIA within this database was 3.7% at 30 days. In the total population of 701 patients, only the OR of 2.7 for hypercholesterolemia (95% CI, 1.0 to 7.3; P = .041) was found to be significant. Subgroup analysis of the 304 symptomatic patients (43%) showed that open-cell stent designs and concentric EPD designs yielded an OR of 4.1 (95% CI, 1.4 to 12, P = .0136) and 3.3 (95% CI, 1.016 to 10, P = .0525), respectively, for 30-day stroke/death/TIA within this database. Analysis of open-cell stent designs and concentric EPD designs in patients with echolucent lesions yielded an OR of 3.1 (95% CI,1.2 to 8.2, P = .0343) and 3.7 (95% CI, 1.3 to 10, P = .0174), respectively, for 30-day stroke/death/TIA. CONCLUSIONS: We conclude that increased analysis of device design variables may be necessary. Particularly in symptomatic patients or with echolucent lesions, closed-cell design and eccentric filters seem superior. Prospective investigation comparing open-cell vs closed-cell stents and eccentric vs concentric filter devices may be warranted.

Aged↗
PubMed2004

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

OBJECTIVE: to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. DESIGN: qualitative in-depth interview study. SETTING: postnatal women of 22 general practices within Oxford City Primary Care Group area. PARTICIPANTS: 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. MEASUREMENTS AND FINDINGS: a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. KEY CONCLUSIONS: in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

Adult↗
PubMed2005

Maternal serum concentrations of BDNF and depression in the perinatal period.

There is accumulating evidence that a deficiency in brain-derived neurotrophic factor (BDNF) plays a critical role in the pathophysiology of depression. This is in line with the postulate that low BDNF levels in serum are associated with depression. However, the regulation of maternal BDNF serum levels in the perinatal period, and its relationship to maternal depression is unknown. In this study, serum BDNF concentrations were measured in 40 pregnant (follow-up: 30th and 37th week of gestation, 1 week and 8 weeks after childbirth) and 40 non-pregnant women (20-40 years old). The Edinburgh Postnatal Depression Scale (EPDS) was assessed in all subjects at all time points. Maternal serum levels of BDNF were markedly decreased, both before and after childbirth (median: <30% of non-pregnant controls). BDNF correlated with decreased Serotonin (5-HT) levels in serum (r>0.6 and p<0.001 at all time points). In contrast, there was no association with altered estrogen, progesterone, dehydroepiandrosterone or cortisol concentrations in serum. There were significantly higher cortisol levels in cases of maternal depression (EPDS scores>9 points) than in cases without depression. There was a trend to a decrease of BDNF and 5-HT levels in cases of maternal depression (as compared to cases without depression), but this was not significant. In conclusion, we demonstrate that women display markedly decreased BDNF serum levels before and after childbirth. This phenomenon might reflect an increased risk for the development of mood disorders in the perinatal period. However, the individual serum concentration of BDNF alone did not predict maternal depression in our study.

Adult↗
PubMed2002

Domestic violence and postnatal depression in a Chinese community.

OBJECTIVES: To study the relationship between domestic violence and postnatal blues/depression in a Chinese community. METHODS: This was a prospective cohort study on 838 women after delivery in a local university teaching hospital. Between October, 2000 and February, 2001, all Chinese speaking women after delivery were invited to be interviewed by a designated research nurse using the Abuse Assessment Screen (AAS) to detect the incidence of domestic violence, the nature of violence and the perpetrator of abuse. Demographic data, pregnancy outcome, Stein's Daily Scoring System (SDSS) scores on day 2 or 3 postdelivery, Edinburgh Postnatal Depression Scale (EPDS) scores on day 2 or 3 postdelivery, 1-2 days after discharge from hospital and at 6 weeks postdelivery were compared between the abused and non-abused groups using Student's t-test, chi(2)-test and Fisher's exact test as appropriate. RESULTS: A total of 139 women (16.6%) had been abused in the last year (the abused group). Of these, 87 (10.4%) had been abused during the current pregnancy. The nature of abuse was mainly verbal. Fourteen women (1.7%) had been sexually abused in the last year. The husband/boyfriend, mother-in-law and employer/colleague were the most common perpetrators of abuse. Socio-demographic factors did not differ between the two groups except that pregnancy was more likely to be unplanned in the abused group (P=0.002). The pregnancy outcome did not differ. However, the abused group had significantly higher SDSS and EPDS scores at all stages of screening (P=0.003, P=0.000, P=0.010 and P=0.001, respectively). CONCLUSION: The findings supported our hypothesis that the effect of domestic violence on Chinese pregnant women is mainly on their psychological well-being.

Adult↗
PubMed2003

Electrophoretic deposition of porous hydroxyapatite scaffold.

Bioactive porous hydroxyapatite (HA) scaffold was fabricated using electrophoretic deposition (EPD) technique in the present work. Bulk HA scaffold was achieved by repeated deposition. The green scaffold was sintered at 1200 degrees C to 82% of the theoretical density. Scanning electron microscopy examination and mercury porosimetry measurement have shown that the porosity remains interconnected and a range of pore size from several microns to hundreds of microns was obtained. X-ray diffraction analysis was performed and confirmed that there is no HA decomposition during the sintering process. Mechanical characterization has also shown that the EPD scaffold possesses excellent properties. Cell culturing experiment was carried out and the result shows that the scaffold bioactivity is not only dependent on the interconnectivity of the pores, but also the pore size.

Biocompatible Materials↗
PubMed2001

Antenatal depression, substance dependency and social support.

BACKGROUND: The purpose of this study was to explore the prevalence of depression and factors associated with depressive mood among pregnant women. METHOD: 391 women who were 14-37 weeks pregnant were evaluated with the Edinburgh Postnatal Depression Screen (EPDS), which has also been validated for prenatal use. Four questionnaires were used in order to explore associated factors: a questionnaire on background and pregnancy data, the Substance Abuse Subtle Screening Inventory (SASSI) and two Social Support Questionnaires (SSQ1 and 2). RESULTS: 7.7% of the total sample screened positive on the EPDS with a cut-off point of 12/13 recommended. Substance dependency and experienced difficulties in social environment had an independently significant association with maternal depression. LIMITATION: The caseness was defined with a self-report instrument. CONCLUSION: Substance dependency and experienced difficulties, especially in relation to friends, partner and own mother, are associated with antenatal depression. It is important to be aware of this when developing interventions in maternity care primary units.

Adult↗