Guidelines for the management of pregnancy in women with cystic fibrosis

Women with cystic fibrosis (CF) now regularly survive into their reproductive years in good health and wish to have a baby. Many pregnancies have been reported in the literature and it is clear that whilst the outcome for the baby is generally good and some mothers do very well, others find either their CF complicates the pregnancy or is adversely affected by the pregnancy. For some, pregnancy may only become possible after transplantation. Optimal treatment of all aspects of CF needs to be maintained from the preconceptual period until after the baby is born. Clinicians must be prepared to modify their treatment to accommodate the changing physiology during pregnancy and to be aware of changing prescribing before conception, during pregnancy, after birth and during breast feeding. This supplement offers consensus guidelines based on review of the literature and experience of paediatricians, adult and transplant physicians, and nurses, physiotherapists, dietitians, pharmacists and psychologists experienced in CF and anaesthetist and obstetricians with experience of CF pregnancy. It is hoped they will provide practical guidelines helpful to the multidisciplinary CF teams caring for pregnant women with CF

Diurnal rhythmic expression of the rhythm-related genes, rPeriod1, rPeriod2, and rClock , in the rat brain

High densities of the mRNA of three rhythm-related genes, rPeriod1 (rPer1), rPer2 , and rClock , which share high homology in Drosophila and mammals, are found in the rat hypothalamic suprachiasmatic nucleus (SCN). The SCN, however, is not the only brain region that expresses these genes. To understand the possible physiological roles of these rhythm-related genes, we examined expression of these genes in different brain regions at various time points in male Sprague--Dawley rats. Using semi quantitative in situ hybridization with 35 S-riboprobes to evaluate mRNA levels, the diurnal rhythmicity of rPer1, and rPer2 mRNA levels was found in the SCN, arcuate nucleus, and median eminence/pars tuberalis. Expression patterns of mRNA for rPer1 and rPer2 , however, were not similar in these brain regions. The rhythmicity in these brain regions was specific, because it was not observed in the cerebellum or hippocampus. Moreover, diurnal changes in rClock mRNA expression were not detected in any of the brain regions examined. These findings suggest that the different expression patterns observed for rPer1, rPer2 , and rClock mRNAs may be attributed to their different physiological roles in these brain regions, and support previous work indicating that circadian rhythms in the brain are widespread.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43939/1/11373_2004_Article_8176.pd

Tropomodulin protects α-catenin-dependent junctional-actin networks under stress during epithelial morphogenesis

10.1016/j.cub.2012.06.025Current Biology22161500-1505CUBL

Rapid handheld continuous electroencephalogram (eeg) has the potential to detect delirium in older adults

Background: Delirium-related biochemical derangements lead to electrical changes that can be detected in electroencephalographic (EEG) patterns followed by behavioral signs and symptoms. Studies using limited lead EEG show a large difference between patients with and without delirium while discriminating delirium from other causes. Handheld rapid EEG devices may be capable of detecting delirium before symptom onset, thus providing an objective physiological method to detect delirium when it is most amenable to interventions. Objective: The aimof this studywas to explore the potential for rapid EEG to detect waveform pattern changes consistent with delirium status. Methods: This prospective exploratory pilot study used a correlational design and mixed models to explore the relationships between handheld portable EEG data and delirium status. Results: While being under powered minimized opportunities to detect statistical differences in EEGderived ratios using spectral density analysis, sleep-to-wake ratios tended to be higher in patients with delirium. Conclusions: Limited lead EEG may be useful in predicting adverse outcomes and risk for delirium in older critically ill patients. Although this population is at the highest risk for mortality, delirium is not easily identified by current clinical assessments. Therefore, further investigation of limited lead EEG for delirium detection is warranted. © 2022 Lippincott Williams and Wilkins. All rights reserved

ECONOMICS AND IMPACT ASSESSMENT: CETERIS PARIBUS OR MUTATIS MUTANDIS

Economic theory frequently uses ceteris paribus assumptions to hold complicating variables constant to analyze the effect of one variable on another. Policy-makers must consider effects of policies with other things changing as they will (i.e., mutatis mutandis). Impact assessment can recon- cile the often narrow approach of economic analysis and the need for broad consideration of implications. The methods of impact assessment can pro- vide a proper place for economic analysis in policy assessment and help to assure that a broad range of impacts are included to determine the economic effects of events and decisions. Copyright 1988 by The Policy Studies Organization.

Parental influences on sperm banking attempts among adolescent males newly diagnosed with cancer

Objective To investigate the influence of parental sociodemographic, communication, and psychological factors on sperm collection attempts among at-risk adolescent males newly diagnosed with cancer. Design Prospective, single group, observational study design. Setting Pediatric oncology centers. Patient(s) Parents (N = 144) of 122 newly diagnosed adolescent males at increased risk for infertility secondary to cancer therapy. Intervention(s) Survey-based assessment of parent factors associated with adolescent collection attempts. Main Outcome Measure(s) Attempt of manual collection of sperm. Result(s) Parental recommendation to bank sperm (odds ratio [OR] 3.72; 95% confidence interval [CI] 1.18–11.76) and perceived self-efficacy to facilitate banking (OR 1.20; 95% CI 1.02–1.41) were associated with an increased likelihood of making a collection attempt. Conclusion(s) Parental recommendation to bank is a critical influence for sperm banking among adolescent males newly diagnosed with cancer. These findings highlight the importance of effective communication between parents, patients, and health-care teams when discussing preservation options. Parent perceptions of their ability to facilitate sperm banking at the time of diagnosis should also be targeted in future interventions. Clinical Trial Registration Number NCT0115226