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PubMed2001

Maternal-fetal interaction in the ABO system: a comparative analysis of healthy mothers and couples with recurrent spontaneous abortion suggests a protective effect of B incompatibility.

We investigated the possible differential effects of A and B blood group materno-fetal incompatibility on human fertility through a comparative analysis of couples with recurrent spontaneous abortion (RSA) and healthy mothers. ABO phenotype was determined in 5180 healthy mothers and their newborn babies from the population of Sassari (Sardinia) and in 1359 healthy puerperae (women who have just given birth) from the population of Rome. Mother-newborn joint ABO distribution in healthy mothers was compared with wife-husband joint ABO distribution in RSA couples. Distortions from expected distribution were evaluated by symmetry analysis. In both RSA couples and healthy mothers significant deviation from expected symmetry patterns were observed. Deviations in RSA are in the opposite direction to those observed in healthy puerperae. The most important difference observed concerned the symmetric joint phenotypes mother (women) A/infant (husband) B (B incompatible) and mother (women) B/infant (husband) A (A incompatible). A low number of B incompatible in RSA couples and a high number of B incompatible in healthy mothers was observed. The phenomenon is much more evident in women aged 24-28 years, a period of maximum fecundity. It is possible that the presence of anti-B immunoglobulin in the mother might have a protective effect against fetal loss in some cases of mother-infant ABO incompatibility.

ABO Blood-Group System↗
PubMed1977

Recent trends in contraceptive use in Mexico.

In 1973 the Mexican government changed its official position on family planning from one of neurtality to one of support. Prior to that time, family planning activities had been limited to the commercial sector and two private programs. As a result of the new policy, all major official health programs began organizing family planning activities. While about the same number of couples were served by the private programs in 1976 as in 1973, the commercial sector grew at over 10 percent per year and official coverage expanded around fivefold. It is estimated that the proportion of eligible women protected by contraception doubled and that the birth rate fell from 43-44 in 1973 to 37-40 by the end of 1976.

Adolescent↗
PubMed2002

Law of universal mortality.

Mortality is arguably the best statistically quantified biological phenomenon. This allows for a physical approach to its study. I establish that in well protected populations, a dominant fraction of mortality at a given age depends on a single parameter only. Such invariance to any other time and space changes is known only in general relativity. It is so mathematically restrictive that, with no other knowledge of experimental data, it is sufficient to predict the exact law. It is universal for species as remote as humans and flies. The law unravels its biologically nonspecific thermodynamic mechanism. It implies that within a couple of years human mortality may be reset to its value at a much younger age. The reversal (albeit not yet as rapid) is consistent with demographic data. For instance, Swedish females, born in 1916, at 48 yr restored their mortality rate 28 yr earlier. The law and its other predictions and implications are also verified. The universal law suggests that a dominant fraction of mortality in well protected populations is just a by-product, which may be eliminated. Total mortality can be significantly decreased.

Journal Article↗
PubMedDate not supplied

Contraception and fertility in the Netherlands.

At the beginning of the 1960s, the Netherlands was basically a conservative society, in which there was little public discussion of birth control or of any sex-related topic. Then, beginning in the 1960s, a series of revolutionary changes in attitudes transformed the Netherlands. The pill was introduced in 1964, and within four years, four out of 10 Dutch women between the ages of 21 and 34 had used it. In 1971, the pill and sterilization were both made available free of charge through the national health insurance plan. By 1974, three-quarters of currently married women 20-42 years of age had ever used the pill, and by 1981, more than 700,000 men and women of reproductive age had had voluntary sterilizations, so that approximately 20 percent of all Dutch couples of reproductive age were protected from pregnancy by sterilization. As might be expected, the wide use of effective contraceptive methods during the late 1960s and the 1970s produced an unprecedented fertility downturn in the Netherlands: The crude birthrate fell from about 20 births per 1,000 population in 1965 to 13 per 1,000 in 1975; the total fertility rate fell from 3.1 births per woman in 1960 to 1.7 in 1975. The birthrate and the abortion rate among teenagers both declined during the 1970s; since sexual activity among teenagers was far more common at the end of the decade than at the start of it, the decline suggests that teenagers used modern contraceptive methods, especially the pill, effectively. At present, contraceptives are widely available, usually at no cost, throughout the Netherlands.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Barrier contraception.

Barrier contraception is a safe, effective, reversible form of contraception acceptable to many couples. The use of barrier contraception may protect against carcinoma of the cervix and sexually transmitted diseases. Distribution and education in the use of barrier contraception does not always require medical supervision. This must make it an attractive form of contraception for agencies supporting family planning programmes in developing countries. The only marketed recent advance in barrier contraception is the collatex sponge. Effectiveness rates range between 9 and 27 pregnancies per 100 woman-years. This is unlikely to make it the first choice of contraception for couples who would find an unintended pregnancy a severe problem, but the sponge will be acceptable to couples who are simply trying to delay a pregnancy. The new surge of interest in barrier contraception could lead to safer more effective forms of contraception being made available to women without medical supervision. This would have many advantages, but could also detract from the ability of family planning clinics to play an important role in preventative medicine for women.

Adrenergic beta-Antagonists↗
PubMed2002

Equipping couples with the tools to cope with predictable and unpredictable crisis events: the PREP Program.

The current article focuses on the application of crisis intervention principles to primary prevention programs for marital distress. The Prevention and Relationship Enhancement Program (PREP) is a universal, empirically-supported preventative intervention program that teaches couples skills that decrease relationship risk factors and increase protective factors. These skills, mainly conflict resolution and communication skills, serve to protect relationships from the negative impact of both normative transitional crises (e.g., marriage) and other non-predictive crises. PREP emphasizes the development and maintenance of intimacy, commitment, and friendship in the relationship, which not only protects couples from the negative ramifications of crisis events, but may also decrease the chance of such crises happening in the first place. Research has shown that PREP significantly decreases multiple indicators of marital distress as much as four years after participation in the program in both clinical and community settings. PREP has also been shown to increase marital satisfaction.

Adaptation, Psychological↗
PubMed1995

Implementation of a formal treatment agreement for outpatient management of chronic nonmalignant pain with opioid analgesics.

We describe the creation and implementation of a formal treatment agreement between patients suffering from chronic nonmalignant pain and the pain management team at our institution. Key features of the agreement include acknowledgement that previous treatment strategies have been inadequate, use of extensive written explanations of the side effects and risks of opioid therapy (including the potential for addiction), outlining of the conditions under which therapy will be conducted, creation of a broad support structure of fully informed health professionals to monitor closely and protect the patient, and emphasis on the importance of pain relief coupled to enhanced function via the active continuation of other therapy. All patients carry a Medical Alert card identifying them as participants in the program. During the past 3 years, a total of 67 patients with refractory nonmalignant pain have been successfully treated with oral opioids using the agreement as a basis for therapy. The treatment agreement provides the necessary structure to formalize this therapeutic approach and emphasizes the mutual responsibilities of the patient and the pain management team.

Ambulatory Care↗
PubMed1976

Shigellosis in the United States: ten-year review of nationwide surveillance, 1964-1973.

In the 10 years 1964-1973, 105,832 isolations of shigellae were reported to the Center for Disease Control through a nationwide surveillance system. The number reported increased by approximately 13% annually, from 5852 in 1964, when only 17 centers reported all 4 quarters; to 16,797 in 1973, when 52 centers reported each quarter. The rate of reported isolations varied from 4.6 per 100,000 persons in 1965 to 9.1 per 100,000 in 1973. Shigella sonnei accounted for 64% of all these isolates and for more than 80% of isolates in 1973. The majority of reported cases of shigellosis occurred in young children and in women of childbearing age. During the 10-year surveillance period, 35 epidemics in 25 states were investigated. Two-thirds of these outbreaks were the result of person-to-person spread; investigations of common-source outbreaks showed the importance of both water and foodstuffs, especially salads, as potential vehicles of contamination. Indian reservations, custodial institutions, and day-care centers were identified as special high-risk settings for the transmission of shigellosis. The emergence of R-factor-mediated antimicrobial-resistance patterns in recent years has necessitated antibiotic sensitivity testing to determine the drug of choice for treatment of individual cases. Initial testing of oral vaccines suggests these vaccines will have only limited usefulness in protecting certain high-risk populations. Public health education coupled with improvements in water and sewerage systems remains the most satisfactory means of control.

Adolescent↗
PubMed1992

Protection of DNA damage by dietary restriction.

Dietary restriction is known to retard the aging processes and delay the onset of age-related neoplastic diseases. The mechanisms underlying these remarkable actions of nutritional intervention are not known in spite of recently intensified research efforts. However, the last couple of years' research on dietary restriction produced strong evidence indicating that its effective antiaging actions might be related to its ability to modulate free radical damage. In the present study, DNA damage and attenuation of the damage by dietary restriction were assessed by measuring 8-hydroxydeoxyguanosine 8-OH dG) in both nuclear DNA (nuDNA) and mitochondrial DNA (mitDNA) fractions. The data show that substantially more damage (approximately 15 times) occurred in mitDNA compared to nuDNA. More interestingly, the DNA damage was significantly attenuated in dietarily restricted rats.

Animals↗
PubMed1998

The Hungarian periconceptional service as a model for community genetics.

OBJECTIVES: This review describes the methods and results of the Hungarian periconceptional service consisting of counselling, examinations and medical interventions. (The term periconceptional is used instead of preconceptional because the early postconceptional period is also involved to this service.) METHODS: The service was based on three steps: check-up examination of reproductive health (i.e., preconceptional screenings), a 3-month preparation for conception, dispensed and/or supervised by qualified nurses, and a better protection in early pregnancy for the most sensitive early development of the embryo for voluntary and eligible couples. RESULTS: Experiences from the coordinating centre of the Hungarian periconceptional service are summarized between February 1, 1984, and January 31, 1999, thus 15 years. Participants with positive family histories, case histories and subjects with genito-urinary infections had a more effective flow towards secondary care. Infertile couples were diagnosed and treated sooner. The periconceptional service is effective for the introduction of periconceptional folic acid-containing multivitamin supplementation and for the reduction of smoking and alcohol consumption in females in the preconceptional period. The rate of major congenital abnormalities (20.6 per 1,000) was significantly lower than expected. CONCLUSIONS: The periconceptional service is feasible and has many benefits. Thus, proper preparation for conception is the earliest and probably the most important effort to prevent genetic diseases.

Journal Article↗
PubMedDate not supplied

Prospective study of cancer patients and their spouses: the weakness of marital strength.

In a prospective study, 133 married cancer patients and their spouses were interviewed within a month of diagnosis and administered three self-reports: The Brief Symptom Inventory (BSI) to assess psychological distress, the Impact of Events Scale (IES) to assess coping, and the Family Adaptability and Cohesion Scales (FACES III) to assess family relations. Patients and spouses were moderately distressed. The patient's psychological distress was explained by the level of intrusion, by the spouse's psychological distress and cohesion which had a protective effect (R2.41). The spouse's distress was explained by intrusion, gender and, to some extent, by the patient's distress (R2.41); but cohesion had no influence. Only half of the group (as couples) reached the last follow-up nearly 2 years later. A disassociation seems to have occurred; family relations, as well as partner's distress, did not have an influence on either the patient's or spouse's distress. The information gathered at the beginning of the study explained about 25% of the distress 2 years later of male patients and their wives, and that of female patients but not of their husbands.

Adaptation, Psychological↗
PubMed1981

Investigations on the galvanic corrosion of multialloy total hip prostheses.

Total hip prostheses combining cobalt and titanium alloys in direct physical contact are currently being used. The purpose of this paper was to investigate the possibility of an accelerated corrosion occurring due to the coupling of these alloys. Electrochemical corrosion studies based on mixed potential and protection potential theories were used to study the in vitro effects of coupling the titanium and cobalt alloys. Verification of these studies was made by direct coupling experiments. Macroscopic examination of' surface features of four retrieved total hip prostheses ranging from 0-6 years implantation were conducted. The electrochemical studies predicted coupled corrosion potentials of -0.22 V and low coupled corrosion rates of 0.02 microA/cm2. Direct coupling experiments verified these results. Cobalt-titanium interfaces on the implants were macroscopically examined, and no instances of extensive corrosion were found. Overall, the in vitro corrosion studies and the examination of retrieved prostheses predicted no exaggerated in vivo corrosion due to the coupling of these cobalt and titanium alloys.

Alloys↗
PubMed1992

Intravesical BCG: current results, natural history and implications for urothelial cancer prevention.

Bacillus Calmette-Guerin (BCG) has been shown in randomized trials to be the most effective agent against superficial bladder tumors. BCG therapy prevents or reduces tumor recurrences, abrogates tumor progression and improves survival over surgery alone. The optimal BCG schedule varies among patients, reflecting a heterogeneous tumor population. Multifocality, high grade (G2,3) and T1 tumors are risk factors for tumor recurrence or invasion. Patients presenting with such features are most likely to benefit from BCG. An incomplete response to BCG portends a high risk of tumor progression. Non-responders have a 40-60% risk of developing muscle invasion or metastases within 10 years, compared with 10-15% for BCG responders. Further, 80% of non-responders progress in the bladder within 3-5 years. After 5 years, relapses are more common in the prostate (13-35%) and upper collecting system (15-33%); one-half of these are invasive tumors. This suggests that intense therapy directed at premalignant and early bladder lesions coupled with a chemoprevention strategy designed to protect the whole urothelium will be required to reverse a pan-urothelial tumor diathesis.

Administration, Intravesical↗
PubMed2003

Endogenous cardiac opioids: enkephalins in adaptation and protection of the heart.

Opiates have been used for thousands of years in the form of opium for relief of pain or fever and to induce sleep. However, it was only in the 1970s that the endogenous ligands for the opiate receptors were identified and termed opioid peptides. Opioid peptides activate G protein-coupled receptors in the central and autonomic nervous system, with marked effects on the regulation of pain perception, body temperature, respiration, heart rate and blood pressure. Cardiovascular regulatory effects of endogenous opioids were initially considered to originate from neural centres in the central nervous system, facilitating a regulatory role in neuro-transmission, as demonstrated by the presynaptic co-release from sympathetic neurones of norepinephrine with enkephalin or acetylcholine with enkephalin. However, opioid peptides of myocardial origin have also recently been shown to play a key role in local regulation of the heart. This brief review highlights the key features of the enkephalin opioids in the heart and the current understanding of their role in development, ageing, cardioprotection, hypertension, hypertrophy, and heart failure.

Journal Article↗
PubMed1995

The new chemicals process at the Environmental Protection Agency (EPA): structure-activity relationships for hazard identification and risk assessment.

Section 5 of the Toxic Substances Control Act (TSCA) does not require any toxicity testing as a prerequisite for submission of a Premanufacturing Notice (PMN) for a new chemical. In order to compensate for the lack of actual test data, a process involving structure-activity relationships (SAR) for assessing hazard potential was constructed. The hazard assessment is then coupled with an estimation of potential exposure to determine potential risk. This process involves the use of multiple interdisciplinary teams that work within a 90-day time frame to complete approximately 2000 risk assessments per year.

Animals↗
PubMed1994

Contraceptive application of the Bioself fertility indicator.

The Bioself fertility indicator is a hand-held electronic device that combines the basal body temperature and calendar methods for planning or preventing pregnancy. A study was undertaken in three centers in the province of Québec, Canada, to evaluate the Bioself device as a contraceptive aid. Eighty-three women were recruited; they accumulated 745 cycles of use. Six unplanned pregnancies occurred from unprotected intercourse during the fertile phase of the cycle, as indicated by the Bioself device. The pregnancy rate was 9.02 per 100 women-years and the one-year discontinuation rate was 32.5%. The low pregnancy rate is attributed to the women's experience in natural family planning, reinforced, in 51% of the cycles, by protection from additional barrier methods. It was concluded that the Bioself device is an effective contraceptive aid for couples who are aware of the pros and cons of natural family planning and desire a noninvasive means of contraception.

Adult↗
PubMed1999

Current status of sustained release formulations in the treatment of hypertension. An overview.

The principal advantages to be gained from controlling the variables of drug release in sustained release formulations are as follows: (i) a more uniform plasma drug profile with fewer occasions when super- or subtherapeutic concentrations of the drug, or its active metabolite(s), occur; and (ii) a smoother therapeutic response over the dosage interval (provided the time-course of drug effects reflects the plasma concentration-time profile). Clinically, this offers the potential to optimise drug therapy and decrease the occurrence of concentration-related adverse effects. In addition, sustained release formulations may increase the likelihood of patient acceptance of therapy, and a once-daily sustained release formulation of a shorter-acting drug that provides a 'residual' therapeutic response at the end of the dosage interval can provide additional 'cover' in comparison with a once-daily conventional (immediate release) formulation. In the treatment of hypertension, there are potential advantages to be gained from continuous 24-hour control of blood pressure (BP), particularly in view of epidemiological evidence linking the apparent underperformance of antihypertensive therapy in some major intervention trials in reducing the occurrence of coronary heart disease to predicted levels with a relative failure to control diurnal BP fluctuations. In this regard, the concept of the trough:peak ratio as a measure of antihypertensive efficacy has gained increasing acceptance during recent years. A sustained release antihypertensive formulation offering an improved plasma concentration-time profile and an adequately high trough:peak ratio may therefore provide more consistent 24-hour BP-lowering activity, with attenuation of early morning BP surges and maximal target organ protection. This, coupled with the fact that sustained release formulations can also provide economic advantages in cardiovascular therapeutics by lowering overall health expenditure (which more than offsets their usually higher acquisition costs in comparison with immediate release formulations), suggests that they may have an increasingly important role to play in the future.

Circadian Rhythm↗
PubMedDate not supplied

Infections in sickle cell anemia: pathogenesis and control.

Splenic dysfunction accounts for the greatest deficit in immune function in children with homozygous SCD. This dysfunction, coupled with the natural immunologic immaturity of all young children subjects the young child with SCD to an immense risk of severe pyogenic infections. To data, experience would suggest that pneumococcal vaccines may provide only modest protection in the child with SCD less than 5 years of age. Antipneumococcal antibody responses are poor in children less than two years of age. All reported failures of pneumococcal vaccine among children with SCD have occurred in children less than three years of age and offending pneumococci have been of groups 6 and 23. Prophylactic antibiotic regimens have yet to be submitted to rigid scientific investigation and their utility in eliminating the risk of pneumococcal sepsis in asplenic hosts is unknown.

Anemia, Sickle Cell↗