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Objective This study aims to determine whether fetal meconium passage is associated with autism. Study design This retrospective birth cohort analysis of 9 945 896 children born in California 1991 to 2008 linked discharge diagnosis and procedure codes for prenatal stressors, meconium-stained amniotic fluid (MSAF) and meconium aspiration syndrome (MAS) with autism diagnoses for 47 277 children through 2012. We assessed the relative risk of autism by meconium status using logistic regression, adjusting for demographic and clinical features. Results Children exposed to meconium (MSAF and MAS) were more likely to be diagnosed with autism in comparison with unexposed children (0.60% and 0.52%, vs 0.47%, respectively). In adjusted analyses, there was a small increase in autism risk associated with MSAF exposure (adjusted relative risk (aRR) 1.18, 95% confidence interval (CI) 1.12 to 1.25), and a marginal association that failed to achieve significance between MAS and autism (aRR 1.08, 95% CI 0.98 to 1.20). Conclusion Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.

Objective: To evaluate the safety and efficacy of intravenous and oral ofloxacin monotherapy in the treatment of laparoscopically documented acute pelvic inflammatory disease (PID).Methods: This study was conducted as an open-label, phase-III, uncontrolled, multicenter study. Patients identified with laparoscopic findings of salpingitis were treated with 400 mg of intravenous ofloxacin every 12 hours followed by 400 mg of oral ofloxacin every 12 hours for 10 to 14 days. Patients were evaluated five times for clinical and microbial efficacy. Since laparoscopy was performed only at admission, pathogens identified laparoscopically were presumed eradicated if they were present on the laparoscopic culture and the patient was clinically cured or improved at final evaluation.Results: Of the 70 patients evaluable for safety (intent-to-treat population), the mean age was 25.6 years. Sixty-one of 70 patients (87%) were cured, one improved, one did not improve, and seven were unevaluable because they discontinued study participation. Fifty-one were evaluable for clinical efficacy: 50 (98%) were cured and one did not improve. Sixteen were evaluable for expanded microbiological efficacy: three had documented Neisseria gonorrhoeae; 12, Chlamydia trachomatis; and one, a mixed infection of both organisms. All cervical, laparoscopic, and endometrial cultured pathogens, including N. gonorrhoeae and C. trachomatis, were eradicated or presumed eradicated at the posttherapy visit. No serious or unexpected adverse events occurred.Conclusions: Ofloxacin monotherapy was effective and well tolerated in the treatment of laparoscopically proven PID in a geographically diverse population. Future studies are necessary to evaluate long-term outcomes and sequelae of PID treatment with single agent therapy. Infect. Dis. Obstet. Gynecol. 7:138–144, 1999.

To examine available data regarding optimal antimicrobial therapy for pelvic inflammatory disease (PID) and to address selected treatment issues confronting clinicians caring for women with PID.--Studies evaluated to help establish the Centers for Disease Control's 1989 Sexually Transmitted Diseases Treatment Guidelines and other reports published since 1985. A MEDLINE search of English-language literature was conducted using the indexing terms "pelvic inflammatory disease" or "pelvic infections" or "salpingitis" and "treatment". In addition, abstracts and bibliographies of articles and books were reviewed.--Studies were selected for detailed review if they evaluated the effectiveness of an antimicrobial regimen for treatment of PID.--All studies were evaluated to determine the numbers of women treated and the percentage with clinical or microbiologic evidence of cure.--A variety of combination antimicrobial regimens are highly effective in providing clinical and microbiologic evidence of cure; few data are available to assess optimal therapy for prevention of late sequelae. Because PID is polymicrobial in cause, recommended antimicrobial regimens are broad-spectrum in coverage.--No single agent that provides sufficient coverage is currently available. Several combination regimens appear highly effective clinically even among women with tubo-ovarian abscess formation. Uncertainties regarding the effectiveness of antimicrobial therapy for prevention of late sequelae complicate decisions regarding the choice among regimens and the appropriateness of ambulatory treatment of women with PID. Pending better data, hospitalization should be strongly considered, where feasible, particularly for those women with PID desiring further childbearing. Sex partners of all women with PID should be treated.

To study the risk factors for preeclampsia and their interactions.We used a nested, case-control study design to analyze data collected in the Delivery Interview Program, 1977-1980, Boston Hospital for Women (now known as the Brigham and Women's Hospital), Boston. Cases (n = 386) of obstetrician-diagnosed preeclampsia were compared with randomly selected controls (n = 2,355). Using multiple logistic regression, we derived maximum likelihood estimates of adjusted odds ratios (ORs) and 95% confidence intervals (CIs).The following risk factors were statistically significantly associated with preeclampsia: urinary tract infection (UTI) during pregnancy (OR 1.6, 95% CI 1.1-2.5), primiparity (OR 3.8, 95% CI 2.8-5.2), black race (OR 1.5, 95% CI 1.1-1.9), less than a high school education (OR 2.0, 95% CI 1.1-3.6), exposure to diethylstilbestrol in utero (OR 2.4, 95% CI 1.2-2.4), body mass index (kg/m2)30 (OR 2.7, 95% CI 1.6-4.4) and cigarette smoking (OR 0.6, 95% CI 0.5-0.8). When evaluating interactions between variables, we found that primiparas who had UTI during pregnancy were five times more likely (OR 5.3, 95% CI 2.9-9.7) to have preeclampsia than were primiparas who did not have UTI during pregnancy.It is possible that the preeclampsia associated with some of the risk factors we identified could be modified by the use of prophylactic drugs or other interventions. The primipara with a UTI would be a most likely beneficiary.

Prophylactic and therapeutic options for reproductive infections are continually shifting. In this review, highlights from the recent literature of anti-infective drugs in obstetrics and gynecology are presented. Several articles offer new insights into the basic pathophysiology of common infections. Others provide novel strategies in prophylaxis for women with recurrent infections and for those undergoing surgical procedures. In the therapy arena, refinements in dosing schedules favor lower doses and shorter courses for some infections. Intriguing data regarding infrequently discussed infectious processes are presented. Finally, as new, more sophisticated agents flood the market, they are compared against the gold standards of treatment.

Many employees are suffering burnout due to work and family-related stress. What are the effects of stress in the workplace? And what can employers do to check the effects of this unseen, but dangerous, enemy?

Receiver instrumentation for the UA/MPIfR Submillimeter Telescope (SMT) is being assured through three different mechanisms. (1) There will be standard facility instruments. Initially, these include 460 GHz and 345 GHz Schottky waveguide frontends, a bolometer, and two AOS backends (supplied by the MPIfR). (2) The MPIfR and UA are both, independently, working on supplementary instrumentation. These instruments are more experimental in nature. And (3) arrangements have been made (and encouraged) with other institutions to bring unique instruments. In this paper, we will describe submillimeter instrumentation developments underway at Steward Observatory.

Corrosion-related problems in oil production and gas-processing operations result in millions of dollars each year in down time, lost production and damaged equipment. Through the use of accepted corrosion-monitoring techniques, these corrosion-related costs can be reduced by assessing potential failures before they occur and monitoring the progress of corrosion control programs. This paper defines several of the monitoring techniques that have been used successfully by Sun Exploration and Production Company and illustrates their application with various case histories.

The origin of the side-chain portion of paralytic shellfish toxins has been determined along with some details of the biosynthetic steps. Saxitoxin of an unknown origin was discovered in the common mackerels, Scomber scombrus Linn. A small pennate diatom, Amphora coffaeiformis C1. was identified as a source of a new type of shellfish toxin, domoic acid found in Canadian mussels.