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Objective: To analyze the relation between fetal acid-base and neonatal status in an observational cohort study of 900 consecutive women with singleton pregnancies at term undergoing elective cesarean section.Methods: The women were divided into 3 groups according to the type of anesthesia administered. Fetal acid-base status was assessed from umbilical cord blood (both artery and vein) and intermediate neonatal outcome was noted.Results: Epidural anesthesia was associated with the highest pH. The lowest pH and the highest pC0(2) values were associated with spinal anesthesia. Although maternal general anesthesia was associated with the highest values for partial pressure and saturation of oxygen in umbilical arterial blood, the newborns were more likely to be depressed than those born following spinal (P=0.0016) or epidural (P=0.0002) anesthesia.Conclusions: If fetal oxygenation is the goal, general anesthesia provides the highest values for partial pressure and saturation of oxygen in umbilical arterial blood. However, epidural anesthesia was associated with better fetal and neonatal status than either spinal or general anesthesia. [ABSTRACT FROM AUTHOR]

Background/aims: Epidemiological studies in humans link adult disease to abnormal growth in utero. In addition to general malnutrition of the foetus, preferential blood flow to the brain and heart may furthermore deprive organs such as the liver, spleen and kidneys of oxygen and macro- and micronutrients. As a consequence, these organs may not develop normally, which predisposes the individual to the so-called metabolic syndrome (syndrome X) in later life. The effects of foetal undernutrition on the growth of some abdominal organs were investigated by comparing the volume of the kidneys, spleen and liver in small-for-gestational-age (SGA) newborn infants with that in appropriate-for-gestational-age (AGA) newborn infants.Methods: In 25 randomly selected AGA infants and 25 SGA infants, who were subdivided into three gestational age groups (<30, 30-36 and 37-40 wk) the volumes of the liver, kidneys and spleen were determined by ultrasonography. Organ volumes were estimated using the standard ellipsoid formula (longitudinal x anteroposterior x transverse diameter x pi/6). Liver/kidney, liver/spleen and kidney/spleen volume ratios were also determined.Results: The volumes of the kidneys and liver differed significantly between AGA and SGA infants in all three gestational age groups (p < 0.0018 and p < 0.029, respectively). The fact that the spleen volume differed only in the 37-40 wk group (p = 0.0002) may indicate that there is a graded relationship across the whole range of normal birthweight. The correlation between the liver volume and birthweight differed significantly between SGA and AGA infants (r = 0.56 vs 0.84, p = 0.04). On the other hand, the volume ratios between the three organs were the same in all groups (p > 0.15).Conclusion: In intrauterine growth retarded infants, foetal growth of the liver and kidneys is more impaired than the body as a whole. Retarded foetal development of these organs may cause metabolic dysfunction, which predisposes to the group of diseases included in the so-called metabolic syndrome or syndrome X. [ABSTRACT FROM AUTHOR]

Background Calcitriol is the active metabolite and hormonal analogue of vitamin D3. It is widely used for the topical treatment of psoriasis showing good tolerability and effectiveness. Objectives To assess the efficacy, tolerability and safety of calcitriol 3 µg/g ointment in mild to moderate plaque psoriasis involving sensitive areas. Methods Sixty patients with a body surface area < 35% were enrolled into a prospective open label clinical study. Patients were treated for 12 weeks with a twice daily calcitriol 3 µg/g topical ointment application. Efficacy and safety were assessed during the therapy and during a 6-month follow-up period. Results The study demonstrated a high clinical remission rate which progressively increased throughout therapy (11.6% at week 4, 28.3% at week 8 and 63.3% at week 12). No serious adverse events and clinically relevant changes of calcium/phosphorus homeostasis were reported. Conclusions The study suggests that calcitriol 3 µg/g ointment, applied twice daily, is an effective topical treatment for chronic psoriatic plaques involving less than 35% of the body surface and sensitive areas. [ABSTRACT FROM AUTHOR]

We reviewed 86 consecutive cases with fetal femur length (FL) below the 10th centile of our reference ranges at midtrimester ultrasonography. Three groups were identified based on perinatal outcome: normal infants (n= 28), newborns with structural and/or chromosomal anomalies (n= 40), small-for-gestational age (SGA) newborns (n= 18). Fetuses with skeletal dysplasias (n= 13) had significantly shorter FL. Aneuploidies were only found in fetuses with malformations other than skeletal dysplasias. The diagnosis of SGA, based on ultrasound abdominal circumference measurement <10th centile, was made 9 weeks (range 5-14) after the finding of a short FL. Half of these cases also developed pre-eclampsia. [ABSTRACT FROM AUTHOR]

Answers questions on red cell transfusions in neonatal care. Question on primary indications for red blood cell transfusion in the premature; Use of recombinant human erythropoietin; Reduction of the number of donors to which the infant is exposed; Pathogenesis of anemia of prematurity.

We reviewed 86 consecutive cases with fetal femur length (FL) below the 10th centile of our reference ranges at midtrimester ultrasonography. Three groups were identified based on perinatal outcome: normal infants (n= 28), newborns with structural and/or chromosomal anomalies (n= 40), small-for-gestational age (SGA) newborns (n= 18). Fetuses with skeletal dysplasias (n= 13) had significantly shorter FL. Aneuploidies were only found in fetuses with malformations other than skeletal dysplasias. The diagnosis of SGA, based on ultrasound abdominal circumference measurement <10th centile, was made 9 weeks (range 5-14) after the finding of a short FL. Half of these cases also developed pre-eclampsia.

Cross-cultural phenomenology is one method of studying mental disorders such as schizophrenia. There are few data of this nature available on Australian aborigines. Using a retrospective medical record review of 39 matched pairs of aboriginal and nonaboriginal patients discharged as schizophrenic from a psychiatric hospital, this study investigated whether any phenomenological differences, using DSM-III-R criteria, existed between the two groups. Of all criteria, bizarre delusions, social deterioration, illness duration and organic exclusion were statistically significant, with fewer aboriginal subjects having documentation for each of these variables. Possible explanations for these findings, including intergroup phenomenological differences and assessment variation, are discussed.