Queries on medication use during pregnancy: characterisation of the Swiss Teratogen Information Service database.

Limited information on medication safety may result in concerns on how to treat pregnant and breast-feeding patients. The Swiss Teratogen Information Service (STIS) provides information to healthcare professionals about medications during pregnancy and breast feeding. Our objective was to describe the queries addressed to the STIS over the past two decades. The STIS maintains a database of queries on pregnancy outcomes after exposure to various substances, which may be a valuable source of information. We initially analysed the general characteristics of all queries. Thereafter, we focused on exposure to medications during singleton pregnancies and associated health-related aspects. From 2000 to 2019, 7148 queries were entered into the database. An increasing number of queries was recorded over the study period, with an average of 357 queries entered into the database per year. Most of the enquirers were physicians; more specifically, gynaecologists/obstetricians (2389/7148; 33.4%) and psychiatrists (1007/7148; 14.1%). Two thirds (4747/7148; 66.4%) of the queries addressed medication intake during pregnancy; the next most frequent queries concerned planned medication in the context of pregnancy (928/7148; 13.0%) or medication use during breast-feeding (873/7148; 12.2%). In more than 50% (3611/7148) of cases, women were treated with more than one drug; altogether, 15193 medications (taken alone or in combination) were identified. The most frequent queries concerned medicines for the nervous system (ATC group N, n = 7042), with selective serotonin reuptake inhibitors (n = 1271) in the leading position, followed by benzodiazepine derivatives (n = 1102) and other antidepressants (n = 780). The next most frequently mentioned drug classes were anti-infectives for systemic use (J, n = 1586) and drugs for the alimentary tract and metabolism (A, n = 1205). Analysis of follow-up information on cases of medication exposure during singleton pregnancies (n = 2672) revealed an offspring malformation rate of 4.2%. The organ system most often affected was the musculoskeletal system, followed by the circulatory system; congenital malformations of the nervous system and chromosomal abnormalities were also seen. The three most frequently documented congenital diagnoses were malformations of cardiac septa, the brain and major arteries. Healthcare professionals often have concerns regarding the treatment of pregnant women with medication, and require professional counselling in this area. A variety of drugs are mentioned in queries addressed to the STIS, of which psycholeptics and psychoanaleptics are the most frequent. Proper guidelines on their use during pregnancy appear particularly urgent

Quantum dot opto-mechanics in a fully self-assembled nanowire

We show that fully self-assembled optically-active quantum dots (QDs) embedded in MBE-grown GaAs/AlGaAs core-shell nanowires (NWs) are coupled to the NW mechanical motion. Oscillations of the NW modulate the QD emission energy in a broad range exceeding 14 meV. Furthermore, this opto-mechanical interaction enables the dynamical tuning of two neighboring QDs into resonance, possibly allowing for emitter-emitter coupling. Both the QDs and the coupling mechanism -- material strain -- are intrinsic to the NW structure and do not depend on any functionalization or external field. Such systems open up the prospect of using QDs to probe and control the mechanical state of a NW, or conversely of making a quantum non-demolition readout of a QD state through a position measurement.Comment: 20 pages, 6 figure

Clinical efficacy of amoxycillin/clavulanate in laparoscopically confirmed salpingitis

To test the efficacy and safety of amoxycillin/clavulanate (Augmenting 102 hospital patients with laparoscopically confirmed acute salpingitis were treated with paren-teral amoxycillin/clavulanate (l.2g qid for three days) followed by oral amoxycillin/ clavulanate (two tablets of 625 mg tid for a further six days). Bacteriological samples were obtained from the cervix uteri and the pouch of Douglas. One hundred patients were assessable for clinical outcome using several variables including pain scores. Amoxycillin/clavulanate alone was effective in 95 patients (95%). Three patients (3%) responded to amoxycillin/clavulanate with marked improvement but another antibiotic was subsequently added to their treatment regimen. Treatment failed in two patients. At follow-up two weeks after hospital discharge, three patients (3.8%) had relapsed or were re-infected. Adverse drug events included one case of drug fever, one case of rash and one case of severe diarrhoea. Treatment was stopped in all three cases. Gastrointestinal reactions, mainly mild diarrhoea, were seen in 31 patients. No clinically relevant changes in haematological or clinical chemical indices were attributable to the amoxycillin/clavulanate treatment. We conclude that amoxycillin/clavulanate is a clinically effective and safe treatment for acute salpingiti

Simultaneous quantification of steroid hormones and endocannabinoids (ECs) in human hair using an automated supported liquid extraction (SLE) and LC-MS/MS – Insights into EC baseline values and correlation to steroid concentrations

Endogenous steroid hormones and endocannabinoids (ECs) are important regulators in the stress response of the human body. For the measurement of chronic stress, hair analysis has been established as method of choice for long-term and retrospective determination of endogenous stress markers. A sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of five steroid hormones (cortisone, cortisol, androstenedione, testosterone, progesterone) and four endocannabinoids (anandamide, palmitoylethanolamide, 2-arachidonylglycerol, oleoylethanolamide) in hair was developed and validated. The hair samples were extracted with methanol and cleaned up with a fully automated supported liquid extraction (SLE) before analysis. Special attention was paid to the difficulties accompanying the quantification of endogenous analytes in hair. Five different strategies for endogenous compound quantification in hair (surrogate analyte, standard addition, background correction, stripped matrix and solvent calibration) were tested and compared. As a result, the approach of the surrogate analyte was used for the quantification of steroid hormones whereas background correction was used for endocannabinoids. The measurement of 58 samples from healthy young adults allowed insights into endocannabinoid ranges in hair and the correlation to steroid hormones. No significant differences in steroid and EC concentration levels of male and female in hair were found, except for testosterone (p < 0.001) and androstenedione (p < 0.0001). Cortisol to cortisone and testosterone to androstenedione concentrations were significantly and positively correlated. There were significant intercorrelations between endocannabinoids

Low specificity of the bacterial index for the diagnosis of bacterial pneumonia by bronchoalveolar lavage

The bacterial index (BI) as defined by the sum of log10 colony-forming units (cfu) of microorganisms per milliliter of bronchoalveolar lavage (BAL) fluid, i.e., a multiplication of the single cfu/ml, has been used to distinguish between polymicrobial pneumonia (BI≥5) and colonization (BI<5). Since many false-positive results are to be expected using this parameter, the diagnostic value of the BI was studied prospectively by obtaining bacteriologic cultures of BAL fluid in 165 consecutive unselected patients. In 27 cases the diagnosis of bacterial pneumonia was established on clinical criteria. In 133 patients pneumonia could be excluded, and in five patients the diagnosis remained unclear. Using a cut-off of ≥105 cfu/ml BAL fluid, sensitivity and specificity for the diagnosis of pneumonia were 33% (9/27) and 99% (132/133), respectively. Sensitivity was mainly influenced by prior treatment with antibiotics, being 70% (7/10) in untreated and 12% (2/17) in treated patients. Applying the BI methodology at a cut-off of ≥ 5, however, resulted in an unacceptably high rate of 16 additional false-positive results, thus lowering the specificity to 87% (116/133;P<0.0001) while increasing the sensitivity to only 41% (11/27;P=0.77). In conclusion, given the high rate of false-positive results, the methodology of the BI is of doubtful value for the diagnosis of bacterial pneumonia by BAL in an unselected patient group. By applying the absolute number of cfu/ml BAL fluid, however, positive bacteriologic cultures of BAL fluid are highly specific for the diagnosis of pneumonia. Their sensitivity is limited by previous antibiotic therap

Towards an intensified process of biomass-derived monomers: The influence of HMF by-products on gold-catalyzed synthesis of 2,5-furandicarboxylic acid

The utilization of biomass and development of intensified processes are essential to establish a sustainable production of chemicals in the future. Herein, we report on a strategy that allows one to directly convert the biomass-derived platform molecule 5-(hydroxymethyl)furfural (HMF) over Au/ZrO2 in aqueous medium to 2,5-furandicarboxylic acid (FDCA), a renewable building block for biobased polymers like polyethylene furanoate. The focus lies on identifying the influence of 5-(hydroxymethyl)furfural synthesis byproducts, like unconverted sugars, levulinic acid, and formic acid as well as the remaining inorganics, on the synthesis of 2,5-furandicarboxylic acid to save the intermediate step of HMF purification. These components were added to the reaction mixture individually and in combination to study their effect. Although most of these substances lowered the FDCA yield, the reaction conditions could be optimized to produce FDCA quantitatively. Only the addition of levulinic acid led to a severe deterioration of the production of FDCA, which was attributed to poisoning of the catalyst. In a realistic technical scenario, the direct oxidation of impure HMF from unconcentrated sugar syrup in high FDCA yield (74%) was demonstrated. Catalyst stability was investigated in the presence of sugars. On the basis of these studies, highly needed recommendations for the HMF synthesis were developed to establish a more sustainable, technically feasible, and intensified process for direct FDCA production from sugars at industrial scales

Investigation of gravity wave activity based on NDMC, NDACC and CTBTO measurements

GRIPS (Ground based Infrared P-branch Spectrometer) airglow measurements allow the derivation of kinetic temperature in the mesopause region during night with a temporal resolution of 10s to 15s. Amongst others, these time series can be used for the investigation of atmospheric dynamics like gravity wave activity. GRIPS measurements are performed in the framework of NDMC – the international Network for the Detection of Mesospheric Change. The project ARISE combines NDMC, NDACC (Network for the Detection of Atmospheric Composition Change) and CTBTO (Comprehensive Nuclear-Test-Ban Treaty Organization)measurements to infer a new 3D image of atmospheric dynamics from ground to mesopause. In this context, GRIPS data of about two to three years collected at the Observatory Haute-Provence, France and Catania, Italy are utilized to derive an index for shortand long-period gravity wave activity on daily and seasonal base. This time period includes also a stratospheric warming event. Potential energy density is calculated and compared with NDACC measurements at Haute-Provence; differences are discussed. For the measurements at the Italian station, comparisons of gravity wave and volcanic activity relying on infrasound array and seismic measurements are performed. First hints for volcanic induced mesopause gravity wave activity are presented

Seasonal and intra-diurnal variability of small-scale gravity waves in OH airglow at two Alpine stations

Between December 2013 and August 2017 the instrument FAIM (Fast Airglow IMager) observed the OH airglow emission at two Alpine stations. A year of measurements was performed at Oberpfaffenhofen, Germany (48.09∘&thinsp;N, 11.28∘&thinsp;E) and 2 years at Sonnblick, Austria (47.05∘&thinsp;N, 12.96∘&thinsp;E). Both stations are part of the network for the detection of mesospheric change (NDMC). The temporal resolution is two frames per second and the field-of-view is 55&thinsp;km&thinsp;×&thinsp;60&thinsp;km and 75&thinsp;km&thinsp;×&thinsp;90&thinsp;km at the OH layer altitude of 87&thinsp;km with a spatial resolution of 200 and 280&thinsp;m per pixel, respectively. This resulted in two dense data sets allowing precise derivation of horizontal gravity wave parameters. The analysis is based on a two-dimensional fast Fourier transform with fully automatic peak extraction. By combining the information of consecutive images, time-dependent parameters such as the horizontal phase speed are extracted. The instrument is mainly sensitive to high-frequency small- and medium-scale gravity waves. A clear seasonal dependency concerning the meridional propagation direction is found for these waves in summer in the direction to the summer pole. The zonal direction of propagation is eastwards in summer and westwards in winter. Investigations of the data set revealed an intra-diurnal variability, which may be related to tides. The observed horizontal phase speed and the number of wave events per observation hour are higher in summer than in winter.</p

Assessment of the cortisol awakening response: expert consensus guidelines

The cortisol awakening response (CAR), the marked increase in cortisol secretion over the first 30–45 min after morning awakening, has been related to a wide range of psychosocial, physical and mental health parameters, making it a key variable for psychoneuroendocrinological research. The CAR is typically assessed from self-collection of saliva samples within the domestic setting. While this confers ecological validity, it lacks direct researcher oversight which can be problematic as the validity of CAR measurement critically relies on participants closely following a timed sampling schedule, beginning with the moment of awakening. Researchers assessing the CAR thus need to take important steps to maximize and monitor saliva sampling accuracy as well as consider a range of other relevant methodological factors. To promote best practice of future research in this field, the International Society of Psychoneuroendocrinology initiated an expert panel charged with (i) summarizing relevant evidence and collective experience on methodological factors affecting CAR assessment and (ii) formulating clear consensus guidelines for future research. The present report summarizes the results of this undertaking. Consensus guidelines are presented on central aspects of CAR assessment, including objective control of sampling accuracy/adherence, participant instructions, covariate accounting, sampling protocols, quantification strategies as well as reporting and interpreting of CAR data. Meeting these methodological standards in future research will create more powerful research designs, thus yielding more reliable and reproducible results and helping to further advance understanding in this evolving field of research