Two- versus three-dimensional ultrasound in the second and third trimester of pregnancy: impact on recognition and maternal-fetal bonding. A prospective pilot study

Objective: To assess the impact of three-dimensional (3D) versus two-dimensional (2D) ultrasound (US) on maternal-fetal bonding. Study design: Prospective randomized pilot study among low risk women with singleton fetuses in the second and third trimester. Dependent on the randomization pattern, US was commenced either with 2D US or 3D US and the effects were recorded with standardized questionnaires. Results: Sixty patients were included. Although the quality of 2D US, assessed by the examinator, was superior to 3D US, maternal recognition was higher with 3-D US (P=0.004). With 2D US, nulliparous patients had significantly more difficulties visualizing the fetus, than multiparous (P=0.03). However, the maternal preference of 3D US had no significant impact on maternal-fetal bonding. Conclusion: Ultrasound had no significant effect on maternal-fetal bonding. Three-dimensional images may facilitate recognition of the fetus, but 3D US did not have higher impact on maternal-fetal bonding. This finding may be a reason not to consider 3D ultrasound for routine scannin

New pyrrole derivatives with potent tubulin polymerization inhibiting activity as anticancer agents including hedgehog-dependent cancer

We synthesized 3-aroyl-1-arylpyrrole (ARAP) derivatives as potential anticancer agents having different substituents at the pendant 1-phenyl ring. Both the 1-phenyl ring and 3-(3,4,5-trimethoxyphenyl)carbonyl moieties were mandatory to achieve potent inhibition of tubulin polymerization, binding of colchicine to tubulin, and cancer cell growth. ARAP 22 showed strong inhibition of the P-glycoprotein-overexpressing NCI-ADR-RES and Messa/Dx5MDR cell lines. Compounds 22 and 27 suppressed in vitro the Hedgehog signaling pathway, strongly reducing luciferase activity in SAG treated NIH3T3 Shh-Light II cells, and inhibited the growth of medulloblastoma D283 cells at nanomolar concentrations. ARAPs 22 and 27 represent a new potent class of tubulin polymerization and cancer cell growth inhibitors with the potential to inhibit the Hedgehog signaling pathway

S2 Praxisleitlinien in Psychiatrie und Psychotherapie Band 2 Behandlungsleitlinie Therapeutische Maßnahmen bei aggressivem Verhalten

Aggressives Verhalten ist im Zusammenhang mit psychischen Erkrankungen kein seltenes Phänomen. Die Psychiatrie sieht sich seit ihren Anfängen mit der schwierigen Aufgabe konfrontiert, einerseits einen wirksamen und humanen Umgang mit aggressiven Patienten zu gewährleisten, der den Schutz der Patienten und ihrer Umgebung in den Vordergrund stellt, der andererseits aber möglichst wenige Restriktionen auf den Patienten ausübt. Diesem Spannungsfeld zwischen therapeutischen und ordnungspolitischen Anforderungen ist die Psychiatrie in der Vergangenheit nicht immer gerecht geworden. Die Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN) hat in dieser S2-Leitlinie auf Grundlage der empirischen Literatur die Thematik systematisch aufgearbeitet. Daraus wurden im anschließenden Expertenkonsens konkrete Handlungsempfehlungen abgeleitet. Die Leitlinie informiert diagnoseübergreifend über Häufigkeit, Formen und Hintergründe aggressiven Verhaltens. Darüber hinaus gibt sie evidenzbasiert praktische Empfehlungen für alle Betroffenen. Damit trägt sie nicht zuletzt auch zur Entstigmatisierung psychisch kranker Menschen sowie der psychiatrisch-psychotherapeutischer Institutionen mit deren Ärzten, Pflegern und Betreuern bei

Severe acute pancreatitis in a critical care unit: a 10-year evaluation

OBJETIVO: Avaliar etiologia, complicações, tratamento, tempo de internação – hospitalar e em centro de terapia intensiva – e mortalidade de todos os pacientes internados por pancreatite aguda no centro de tratamento intensivo do Hospital de Clínicas de Porto Alegre, no período de janeiro de 1990 a dezembro de 1999. MATERIAIS E MÉTODOS: Realizamos um estudo de coorte histórico, no qual foram avaliados 57 pacientes, 37% do sexo feminino e 63% do sexo masculino, com média de idade de 48 ± 17 anos. Os pacientes foram divididos em dois grupos – sobreviventes (n=26;45,6%) e não-sobreviventes (n=31;54,4%) –, e foram comparados quanto a tempo de internação, critérios de Ranson e de Glasgow modificados, APACHE II (acute physiology and chronic health evaluation), falências orgânicas, procedimentos cirúrgicos, nutrição parenteral e antibióticos recebidos RESULTADOS: As etiologias mais freqüentes foram alcoólica (37%) e biliar (31%). A mortalidade foi de 54,4%. Os sobreviventes apresentaram maior tempo de internação que os não-sobreviventes (47 ± 36 dias contra 21 ± 20 dias). Os não-sobreviventes apresentaram maiores taxas de falências orgânicas (respiratória, renal e cardiovascular) e maior número de critérios de Ranson e de Glasgow modificados, quando comparados aos sobreviventes. Os parâmetros restantes foram semelhantes entre os dois grupos. CONCLUSÕES: Para melhor avaliar os motivos da alta taxa de mortalidade identificada neste grupo, neste período, seria necessário um trabalho prospectivo com melhor controle dos fatores interferentes e que incluísse ainda a avaliação dos casos de pancreatite aguda com critérios de gravidade que não são admitidos no centro de tratamento intensivo.OBJECTIVE: To evaluate etiology, complications, treatment, hospital and intensive care unit stay and mortality in all patients hospitalized in the intensive care unit of Hospital de Clínicas de Porto Alegre with acute pancreatitis, from January 1st, 1990 to December 31st, 1999. MATERIALS AND METHODS: We performed a historical cohort study with 57 patients, 37% female and 63% male, with an age average of 48±17 years. Patients were classified in two groups – survivors (n=26, 45.6%) and non-survivors (n=31, 54.4%) – and compared considering hospital and intensive care unit stay, Ranson’s and modified Glasgow’s signs, APACHE II (acute physiology and chronic health evaluation), organ failure, surgery, parenteral nutrition and antibiotics. RESULTS: The most common causes of severe acute pancreatitis were alcohol (37%) and gallstones (31%). Mortality was 54.4 %. Hospital stays were longer for survivors than for non-survivors. Non-survivors presented more organ failures (respiratory, renal and cardiovascular failures) and more Ranson’s and modified Glasgow’s signs than survivors. Other parameters were similar in both groups. CONCLUSIONS: In order to better evaluate the reasons for the high rate of mortality identified in the present group in the studied period it would be necessary to perform a prospective study with stronger control of the interfering factors, including an evaluation of the cases of severe acute pancreatitis that are not admitted in the intensive care unit

Design and structure-activity relationships of potent and selective inhibitors of undecaprenyl pyrophosphate synthase (UPPS): tetramic, tetronic acids and dihydropyridin-2-ones.

Based on a pharmacophore hypothesis substituted tetramic and tetronic acid 3-carboxamides as well as dihydropyridin-2-one-3-carboxamides were investigated as inhibitors of undecaprenyl pyrophosphate synthase (UPPS) for use as novel antimicrobial agents. Synthesis and structure-activity relationship patterns for this class of compounds are discussed. Selectivity data and antibacterial activities for selected compounds are provided

Severe acute pancreatitis in a critical care unit: a 10-year evaluation

OBJETIVO: Avaliar etiologia, complicações, tratamento, tempo de internação – hospitalar e em centro de terapia intensiva – e mortalidade de todos os pacientes internados por pancreatite aguda no centro de tratamento intensivo do Hospital de Clínicas de Porto Alegre, no período de janeiro de 1990 a dezembro de 1999. MATERIAIS E MÉTODOS: Realizamos um estudo de coorte histórico, no qual foram avaliados 57 pacientes, 37% do sexo feminino e 63% do sexo masculino, com média de idade de 48 ± 17 anos. Os pacientes foram divididos em dois grupos – sobreviventes (n=26;45,6%) e não-sobreviventes (n=31;54,4%) –, e foram comparados quanto a tempo de internação, critérios de Ranson e de Glasgow modificados, APACHE II (acute physiology and chronic health evaluation), falências orgânicas, procedimentos cirúrgicos, nutrição parenteral e antibióticos recebidos RESULTADOS: As etiologias mais freqüentes foram alcoólica (37%) e biliar (31%). A mortalidade foi de 54,4%. Os sobreviventes apresentaram maior tempo de internação que os não-sobreviventes (47 ± 36 dias contra 21 ± 20 dias). Os não-sobreviventes apresentaram maiores taxas de falências orgânicas (respiratória, renal e cardiovascular) e maior número de critérios de Ranson e de Glasgow modificados, quando comparados aos sobreviventes. Os parâmetros restantes foram semelhantes entre os dois grupos. CONCLUSÕES: Para melhor avaliar os motivos da alta taxa de mortalidade identificada neste grupo, neste período, seria necessário um trabalho prospectivo com melhor controle dos fatores interferentes e que incluísse ainda a avaliação dos casos de pancreatite aguda com critérios de gravidade que não são admitidos no centro de tratamento intensivo.OBJECTIVE: To evaluate etiology, complications, treatment, hospital and intensive care unit stay and mortality in all patients hospitalized in the intensive care unit of Hospital de Clínicas de Porto Alegre with acute pancreatitis, from January 1st, 1990 to December 31st, 1999. MATERIALS AND METHODS: We performed a historical cohort study with 57 patients, 37% female and 63% male, with an age average of 48±17 years. Patients were classified in two groups – survivors (n=26, 45.6%) and non-survivors (n=31, 54.4%) – and compared considering hospital and intensive care unit stay, Ranson’s and modified Glasgow’s signs, APACHE II (acute physiology and chronic health evaluation), organ failure, surgery, parenteral nutrition and antibiotics. RESULTS: The most common causes of severe acute pancreatitis were alcohol (37%) and gallstones (31%). Mortality was 54.4 %. Hospital stays were longer for survivors than for non-survivors. Non-survivors presented more organ failures (respiratory, renal and cardiovascular failures) and more Ranson’s and modified Glasgow’s signs than survivors. Other parameters were similar in both groups. CONCLUSIONS: In order to better evaluate the reasons for the high rate of mortality identified in the present group in the studied period it would be necessary to perform a prospective study with stronger control of the interfering factors, including an evaluation of the cases of severe acute pancreatitis that are not admitted in the intensive care unit