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Obstetric anaesthesia can be potentially hazardous. The physiological changes of pregnancy place an extra burden on the pregnant patient, particularly on the respiratory and cardiovascular systems, which may then be further strained by the introduction of general or regional anaesthesia in the peripartum period. Many of these physiological changes can be exacerbated by obesity, and the care of obese parturients can present extra challenges to anaesthetists. Obesity is increasing in prevalence globally, and these patients are presenting for antenatal care with increasing frequency. This article reviews the changes in physiology associated with obesity and pregnancy, considers some of the hazards of providing anaesthesia to obese parturients and suggests some techniques which may help to provide safer care to these challenging patients.

Overexpression of cyclin D1 is commonly observed in human cancers. The best-known association is with mantle cell lymphoma in which there is a t(11:14) translocation. We describe an unusual case of high-grade T cell lymphoma, presenting as rapidly enlarging, painless lymphadenopathy in an 80-year-old female. She died 13 months after presentation, having relapsed after chemotherapy. The lymph node showed diffuse effacement by blastic lymphoid cells, positive for T cell markers and cyclin D1. Molecular genetics investigations found t(11:14) translocation. There was definite T cell clonality demonstrating clonal rearrangement of both T cell receptor gamma and beta genes but no convincing evidence of B cell clonality. These data represent the first documented case where deregulation of the cyclin D1 expression has been implicated in human T cell lymphoreticular malignancy.

The integration of information technology into the health care system is central to the UK government’s strategy to improve the delivery of health care. There remains uncertainty about how this new technology is being used by practitioners, and the impact it is having in their everyday work and relationships with patients. The objectives of this study were to identify experiences and attitudes of general practitioners (GPs) about the use of the Internet as an information resource for themselves and for their patients, and their perceptions of the obstacles to using it, and to describe how GPs view the potential and limitations of the use of electronic communication with both fellow professionals and patients, and to explore the perceived impact on the GPs’ roles and relationships. A qualitative study design involving interviews with 24 GPs in North West England was used. The methods involved semi-structured interviews with a purposive sample of GPs to explore their views on the use of the Internet in their day-to-day work. Interviews were recorded and transcribed verbatim. Data was analysed with the interview schedules being modified in the light of emerging themes. There were two main themes: the Internet as an information source for GPs and their patients, and the use of email as a form of communication between themselves and patients, and between health professionals in primary and secondary care. Whilst GPs appreciate that the Internet could offer an exceptional quantity of information that could be used within the consultation and which might improve patient management, they cite many barriers to the effective acquisition and use of such a resource. Similarly, GPs reported limiting their use of the Internet to assist communication between the GP and the patient, and were concerned about the Internet duplicating work rather than reducing it. GPs seemed reluctant to grasp the potential that they perceived that the Internet might offer. The current configuration of primary care, and the role of the GP within it, is likely to limit the uptake and use of the Internet as a means of extending opportunities for patient care.

Abstract: The fitness of crop-wild hybrids can influence gene flow between crop and wild populations. Seed predation levels in crop-wild hybrid plants can be an important factor in determining plant fitness, especially in large-seeded crops such as sunflower. To determine patterns of pre-dispersal seed predation, seeds were collected from wild sunflowers (Helianthus annuus L.) and wild×crop F1 hybrids at three experimental field sites in eastern Kansas. Seed heads were dissected and each seed was counted and scored for categories of seed damage by lepidopteran and coleopteran larvae. Hybrid seed heads showed significantly higher levels of insect-damaged seeds. The average hybrid plant had 36.5% of its seeds (or 45.1 seeds per plant) eaten by insect larvae while the average wild plant lost only 1.8% (or 95 seeds) to seed predators. Hybrid populations had higher levels of total insect damage even when date of flowering, flower head diameter, and the number of open heads within the study site were accounted for. These results suggest that the reduced fecundity of F1 crop-wild sunflower hybrids demonstrated in other studies may be augmented by the increased seed predation in hybrid flower heads. Fecundity estimates of crop-wild hybrid and wild plants that disregard differential seed predation levels may not accurately reflect the actual relative contributions of hybrid and wild plants to future generations.

The anther-smut fungus Ustilago violacea sporulates in flowers of the dioecious host plant Silene alba. Growth chamber comparisons of healthy and diseased plants, with the genetic background of host and pathogen controlled, revealed that fungal infection increases the number of flowers produced per plant and decreases the size of individual flowers. There were few consistent effects of plant genotype or fungal isolate on diseased flower traits, but differences between the plant sexes were apparent. Stimulation of flower production is proportionally greater in females than males: thus, although healthy male plants produce many more flowers than healthy females, sexual differences in diseased flower number are reduced. Sexual differences in diseased flower size also exist, with male flowers smaller than females. A field inoculation study confirmed dimorphism in diseased flower size and demonstrated that spore production per flower was greater for males than females for all flower size classes.

Naturally established individuals of Plantago lanceolata with the inflorescence disease caused by Fusarium moniliforme var. subglutinans had more inflorescences and were more likely to be male-sterile than healthy plants. Half-sib families planted in the field varied in the percentage of diseased plants, the number of inflorescences per plant, the incidence of male-sterility, and the pattern of inflorescence phenology. The rankings of families with respect to disease incidence was, however, not simply related to their reproductive phenotypes. Plants derived from field genotypes with a history of disease were slightly more likely to become diseased than plants derived from healthy genotypes. Inflorescence infection was more severe on plants derived from genotypes with a known history of disease. Since the fungus reduces seed production in the plants it infects, differential incidence of disease based on plant phenotype and genotype may have ecological and evolutionary consequences for the host population.

Disese induced by Albugo candida or Peronospora parasitica was found to have significant effects on the survival and reproductive output of affected individuals of Capsella bursa-pastoris. The time of infection by either pathogen was of considerable importance in determining the ultimate effect of disease. Systemic (primary) infection of seedling plants led to a high degree of mortality (88%) prior to reproductive maturity, however, localized or systemic secondary infection did not affect survival. Fruit production of surviving infected plants was negatively correlated with disease severity.

Twenty cloned genotypes of Silene albadiffered greatly (0–100%) in the percentage of flowering plants that became diseased by the anther‐smut fungus Ustilago violaceafollowing natural spore dispersal in a two‐year field experiment. Male genotypes with the highest percentage of disease had high rates of flower production; this trait may increase the probability of spore deposition on flowers, a common site of infection. Because of this relationship, male genotypes with the highest percentage of disease also produced the most healthy flowers in the two‐year period. Flowering early in the season was also a predictor of high disease levels for male genotypes in the first year. Variation among female genotypes in disease levels was not correlated with either flower production or phenology, suggesting that the sexes differ in their interaction with the pathogen. Plants of both sexes that remained nonreproductive the first year but flowered the second year could become diseased due to infection of vegetative tissue. Disease levels of the genotypes following natural spore dispersal were not correlated with disease levels of the genotypes following inoculation of vegetative tissue. This discrepancy points out that the methodology used to investigate genetic variation in disease resistance may affect the results obtained.

The identity of neighbouring plants in a population is thought to affect the disease levels of an individual plant: disease levels are expected to be higher for susceptible plants surrounded by other susceptible plants as compared to susceptible plants that have resistant plants as neighbours. To explore this idea, plants in a natural population of the annual sunflower, Helianthus annuus, were scored in 1988 for levels of the rust pathogen Puccinia helianthi. Progeny of plants with high rust levels (families predicted to be susceptible to the disease) were grown in 1989 in a series of field plots at either high frequency (all plants in a plot of one family) or in low frequency (a plot with plants of many families). There was a positive correlation between rust levels of the parent plants in 1988 and their progeny in 1989, but the frequency of a family in the experimental plots did not affect rust levels. Generally low rust levels at the site, as well as other factors, probably contributed to the absence of a frequency effect. Herbivore levels and plant survival and reproduction varied among plots, but were not affected by the plot composition.

The spatial scale of genetic diversity among patches of a host plant could affect the likelihood of pathogen adaptation to the host. If host patches are genetically distinct, pathogen adaptation to local host genotypes may occur. To study this issue, we focused on the ecological and genetic interactions between two rust fungi, Puccinia seymouriana and P. sparganioides, and the clonal prairie grass, Spartina pectinata. In a field transplant experiment, disease levels differed among plants from different patches, suggesting variation in resistance. Over a 4.5-km scale, disease levels were not higher on plants transplanted back into their source patch as opposed to other locations, providing no evidence for local adaptation in the pathogen. However, on the spatial scales examined (ranging from 0.2 km to 120 km), there was no relationship between the physical distance separating host patches and their similarity in isozyme banding patterns, implying that plants from more distant patches are not necessarily more genetically distinct than plants from nearby patches. Plants derived from the most distant location had, on average, the lowest mean number of pustules at the end of the summer, suggesting the need for reciprocal transplant studies to be performed on a larger spatial scale.

It is well documented that pathogens can affect the survival, reproduction, and growth of individual plants. Drawing together insights from diverse studies in ecology and agriculture, we evaluate the evidence for pathogens affecting competitive interactions between plants of both the same and different species. Our objective is to explore the potential ecological and evolutionary consequences of such interactions. First, we address how disease interacts with intraspecific competition and present a simple graphical model suggesting that diverse outcomes should be expected. We conclude that the presence of pathogens may have either large or minimal effects on population dynamics depending on many factors including the density-dependent compensatory ability of healthy plants and spatial patterns of infection. Second, we consider how disease can alter competitive abilities of genotypes, and thus may affect the genetic composition of populations. These genetic processes feed back on population dynamics given trade-offs between disease resistance and other fitness components. Third, we examine how the effect of disease on interspecific plant interactions may have potentially far-reaching effects on community composition. A host-specific pathogen, for example, may alter a competitive hierarchy that exists between host and non-host species. Generalist pathogens can also induce indirect competitive interactions between host species. We conclude by highlighting lacunae in our current understanding and suggest that future studies should (1) examine a broader taxonomic range of pathogens since work to date has largely focused on fungal pathogens; (2) increase the use of field competition studies; (3) follow interactions for multiple generations; (4) characterize density-dependent processes; and (5) quantify pathogen, as well as plant, population and community dynamics.

Four genotypes of P. lanceolata were grown to maturity at combinations of two levels of atmospheric CO2 concentrations and two temperature conditions. Seed weight was determined, and seed germination and seedling growth were measured for the progeny of each genotype under the same environmental conditions. Overall, high CO2 levels decreased seed weight, increased germination percentage and rate, and increased seedling size. Families differed in their response to CO2 enrichment, and to combinations of CO2 and temperature levels for several characters. These results suggest the existence of genetic variability in P. lanceolata in response to CO2 enrichment.

Describes a broad treatment strategy for the game “Allergic,” designed to incorporate both medical and psychological treatments. The steps of the approach include medical evaluation, patient and family psychological/script assessment, development of hypotheses and relevant interventions about “family rules,” plan a physical health regimen, intervene directly in the Allergic game employing hypotheses formed from observation of the patient and the family, and development and implementation of individual contracts for specific goals for the patient for the ensuing 3 to 5 years. This approach is adaptable to the clinical orientation of the therapist and to the family members available for treatment.

At low densities, Plantago lanceolata was less likely to have the inflorescence disease caused by the fungus Fusarium moniliforme var. subglutinans. Where the disease was found, as host density increased, the proportion diseased remained constant or decreased. The pathogen's inability to exploit high host densities may be due to both the long disease cycle and the reduced efficiency of disease spread in heterogeneous habitats. Diseased plants were randomly spaced early in the summer but were later found in clusters, probably as a result of localized spore dispersal. Spatial patterns of disease levels remained constant from year to year.

Identifies “Allergic” as a game played by persons who experience an elation-to-depression reaction after the ingestion of certain substances. Symptoms may range from depression, schizophrenia, migraine headaches, or allergic rashes, to alcoholism, drug abuse, or obesity. Payoffs of the game include social isolation, unexpressed anger, with possible physical damage. “Allergic” is compared to Alcoholic games, the script matrix is described, and the significance of its passage through generations is emphasized.

Transepidermal water loss (TEWL) is the most widely used objective measurement for assessing the barrier function of skin in healthy individuals but also patients with skin diseases that are associated with skin barrier dysfunction, such as atopic dermatitis. TEWL is the quantity of condensed water that diffuses across a fixed area of stratum corneum to the skin surface per unit time. The water evaporating from the skin is measured using a probe that is placed in contact with the skin surface and contains sensors that detect changes in water vapor density. TEWL can be measured using an open-chamber, unventilated-chamber, or condenser-chamber device. It is a sensitive measure that is affected by properties of the surrounding microclimate such as environmental humidity, temperature, and airflow and should be measured under controlled conditions. TEWL varies significantly across different anatomical sites and also depends on sweat gland activity, skin temperature, and corneocyte properties. Here we describe how to optimally use TEWL measurements as a skin research tool in vivo and in vitro.

Presents letters to the editor referencing articles and topics discussed in previous issues of the periodical "International Gymnast." Comments on the poster of Ukrainian gymnast Darya Zgoba published in the November 2005 issue; "Sport or Soap Opera," which focused on the NBC television coverage of the 2005 national gymnastics competition; Response to a letter by Ronnie Baldwin on the scoring system in gymnastics.