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Background and objective Routine antenatal anti-D prophylaxis (RAADP) to RhD-negative women is most often administered in gestational age (GA) 28-30 weeks with the next anti-D dose administered postpartum. The aim of this study was to analyse the proportion of RhD-negative women where RAADP is not detectable at term and in a pilot study to investigate whether RAADP administered in GA 28 and 38 results in detectable levels at term, post-term and post-delivery. Materials and methods In a retrospective analysis, 4280 RhD-negative women carrying an RHD positive fetus were included and the proportion with a negative antibody screen at delivery was determined. In the second part, 39 pregnancies were included prospectively, a second dose of RAADP was administered in GA 38 weeks, and anti-D was quantified before the second dose and then weekly for 5 weeks. Results In the retrospective analysis, 20·5% (856/4280) with RAADP administered in GA 28 were negative in routine antibody screening at delivery. In the small prospective study, 18% (7/39) had a negative antibody screen and 26% (10/39) had levels below 0·005 IU/ml, in the quantification assay, in GA 38. Anti-D prophylaxis administered in GA 38 showed detectable levels of anti-D up to 30 days post-delivery, with concentration at delivery 0·060 ± 0·034 IU/ml (mean ± SD). Conclusion Approximately 20% of the RhD-negative women show non-detectable levels of anti-D at term. A second dose of RAADP at GA 38 results in stable concentrations of anti-D at term, post-term and post-delivery, but with large interindividual variation.

20 individuals working organic chemistry and 11 theologians (referents) from the same university were investigated for frequencies of micronuclei in cultured lymphocytes. The chemists had been exposed for 3 to 36 (mean 12) years. No effect of the chemical exposure was found on the micronucleus frequencies. The lack of effect may be due to the improvement of the work environment in chemical laboratories.

Objective To estimate the incidence of RhD immunisation after implementation of first trimester non-invasive fetal RHD screening to select only RhD negative women carrying RHD positive fetuses for routine antenatal anti-D prophylaxis (RAADP). Materials and Methods We present a population-based prospective observational cohort study with historic controls including all maternity care centres and delivery hospitals in the Stockholm region, Sweden. All RhD negative pregnant women were screened for fetal RHD genotype in the first trimester of pregnancy. Anti-D immunoglobulin (250–300 µg) was administered intramuscularly in gestational week 28–30 to participants with RHD positive fetuses. Main outcome measure was the incidence of RhD immunisation developing during or after pregnancy. Results During the study period 9380 RhD negative women gave birth in Stockholm. Non-invasive fetal RHD genotyping using cell-free fetal DNA in maternal plasma was performed in 8374 pregnancies of which 5104 (61%) were RHD positive and 3270 (39%) RHD negative. In 4590 pregnancies with an RHD positive test the women received antenatal anti-D prophylaxis. The incidence of RhD immunisation in the study cohort was 0.26 percent (24/9380) (95% CI 0.15–0.36%) compared to 0.46 percent (86/18546) (95% CI 0.37 to 0.56%) in the reference cohort. The risk ratio (RR) for sensitisation was 0.55 (95% CI 0.35 to 0.87) and the risk reduction was statistically significant (p = 0.009). The absolute risk difference was 0.20 percent, corresponding to a number needed to treat (NNT) of 500. Conclusions Using first trimester non-invasive antenatal screening for fetal RHD to target routine antenatal anti-D prophylaxis selectively to RhD negative women with RHD positive fetuses significantly reduces the incidence of new RhD immunisation. The risk reduction is comparable to that reported in studies evaluating the outcome of non selective RAADP to all RhD negative women. The cost-effectiveness of this targeted approach remains to be studied.

Objective-To study the prevalence of Enterobius vermicularis and its association with finger sucking in young Swedish children.Design-Cross-sectional survey with a questionnaire for symptoms of infestation with Enterobius vermicularis, and the children's habit of finger sucking (including fingernail biting). Perianal tape-test for identification of eggs of Enterobius vermicularis.Setting-Primary care, day-care centres, and schools in a Swedish middle-sized town (approx. 80 000 inhabitants).Participants-172 children of both sexes, 4–10 years old.Main outcome measures-The prevalence of Enterobius vermicularis and its association with finger sucking.Results−21% of the children were symptom-free carriers of Enterobius vermicularis, and finger sucking was strongly associated with a positive tape-test (p=0.01).Conclusion-More children than previously known seemed to be symptom-free carriers of Enterobius vermicularis. Finger sucking should be considered when treating infested children and especially those with ...

Micronuclei were induced in human lymphocytes by mitomycin C or gamma radiation. After the incubation the cells were separated in B- and T-cells by an immunomagnetic method, i.e., Dynabeads. The cultures were stimulated by PHA. The effect of different incubation times (60-110 h) as well as different doses of mitomycin C (0-100 nmol/l) and gamma radiation (0-2 Gy) at an incubation time of 72 h were studied. There were significantly higher frequencies of micronuclei in B- than in T-cells, when micronuclei were induced by mitomycin C. This was not found with gamma radiation, probably because of a cytotoxic effect of this agent on the B-cells.

For 26 chloralkali workers exposed to inorganic mercury and 26 age-matched, occupationally unexposed referents, the frequency and size distribution of micronuclei were determined in peripheral lymphocytes stimulated with either phytohemagglutinin or pokeweed mitogen. For the exposed workers the mean concentrations of mercury in urine, plasma, and erythrocytes were 16 nmol/mmol of creatinine, 48 nmol/l, and 78 nmol/l, respectively, and their mean exposure time was 10 years. Neither the frequency nor the size of micronuclei was significantly different in the two groups; nor were there any correlations to current mercury levels. However, in the exposed group, and with phytohemagglutinin as the mitogen, a statistically significant correlation between previous exposure to mercury (cumulative exposure or number of blood mercury peaks) and the frequency of micronuclei was found. This association was also present when the effects of age and smoking were allowed for, and it may indicate an accumulation of cytogenetic effects in T-lymphocytes.

The metabolic origin of the ansa chain and chromophore of rifamycin S has been investigated by studying the incorporation of radioactive and 13C-enriched precursors. A simplified degradation scheme has been utilised to cleave chemically the radioactive antibiotic into constituent chromophore and ansa chain. Rifamycin S labelled with [3-14C]propionate and [Me-3H]methylmalonate have the same pattern of isotope distribution. Unlabelled propionate efficiently dilutes the incorporation of [Me-3H]methylmalonate but the reverse is not true. Although the results of [2-14C]malonate and [2-14C]acetate incorporation were inconclusive owing to randomisation, the proton-decoupled carbon magnetic resonance spectrum of rifamycin S biogenetically enriched with [2-13C]malonate revealed a specific incorporation into C-5 and C-18. We propose that the polyketide chain is formed by a linear condensation, in the appropriate sequence, of eight methylmalonates and two malonates with the subsequent esterification of the C-25 hydroxyl with acetate. Two precursors were found preferentially to label the chromophore: [3,4-14C2]glucose and [1-14C] glycerate. Out of the seven carbons in the chromophore not deriving from acetate or propionate only C-1 and C-10 appeared significantly enriched by [1-13C] glucose. This labelling pattern, coupled with the 14C incorporation data, suggests that the chromophore may derive from an intermediate of the common pathway of aromatic biosynthesis, before the level of shikimate.

For 20 glass-reinforced plastics workers exposed to styrene and 22 unexposed referents, the frequency and size distribution of micronuclei were determined for lymphocytes stimulated with phytohemagglutinin or pokeweed mitogen, and white blood cell counts were made. Furthermore, chromosome aberrations were scored for 11 of the exposed subjects and 15 of the referents. The mean level of styrene in the breathing zone of the workers was 56 mg/m3. Workers exposed to styrene did not show an increase in any of the cytogenetic end points studied when the effect of age and smoking was allowed for in a multiple regression analysis. A significant 30% increase in the number of peripheral monocytes was observed for the exposed workers. No correlations between the cytogenetic and hematological tests on one hand and the length of exposure time on the other could be detected.

Eighteen individuals exposed to lead in their work with repair and reconditioning of car radiators were investigated regarding blood lead levels and frequencies of lymphocyte micronuclei. The micronuclei werc analyzed in cells with preserved cytoplasm. The lead-exposed group was compared with 12 white-collar workers with no occupational lead exposure. The mean blood lead levels were 2.3 (range 1.50-3.30) and 0.42 (range 0.20-1.05) Kmolil, respectively, with no overlapping of exposed subjects and controls. There was no effect of lead exposure when the influences of age, smoking and drug intake were allowed for in a multivariate analysis. On the other hand, there was a striking effect of age on the frequency of micronuclei.