Substance misuse problems during pregnancy with special emphasis on buprenorphine

Maternal drug abuse during pregnancy endangers the future health and wellbeing of the infant and growing child. On the other hand, via maternal abstinence, these problems would never occur; so the problems would be totally preventable. Buprenorphine is widely used in opioid maintenance treatment as a substitute medication. In Finland, during 2000 s buprenorphine misuse has steadily increased. In 2009 almost one third of clientele of substance treatment units were in treatment because of buprenorphine dependence. At Helsinki Women s Clinic the first child with prenatal buprenorphine exposure was born in 2001. During 1992-2001 in the three capital area maternity hospitals (Women s clinic, Maternity hospital, Jorvi hospital) 524 women were followed at special antenatal clinics due to substance abuse problems. Three control women were drawn from birth register to each case woman and matched for parity and same place and date of the index birth. According to register data mortality rate was 38-fold higher among cases than controls within 6-15 years after index birth. Especially, the risk for violent or accidental death was increased. The women with substance misuse problems had also elevated risk for viral hepatitis and psychiatric morbidity. They were more often reimbursed for psychopharmaceuticals. Disability pensions and rehabilitation allowances were more often granted to cases than controls. In total 626 children were born from these pregnancies. According to register data 38% of these children were placed in out-of-home care as part of child protection services by the age of two years, and half of them by the age of 12 years, the median follow-up time was 5.8 years. The risk for out-of-home care was associated with factors identifiable during the pre- and perinatal period. In 2002-2005 67 pregnant women with buprenorphine dependence were followed up at the Helsinki University Hospital, Department of Obstetrics and Gynecology. Their pregnancies were uneventful. The prematurity rate was similar and there were no more major anomalies compared to the national statistics. The neonates were lighter compared to the national statistics. They were also born in good condition, with no perinatal hypoxia as defined by standard clinical parameters or certain biochemical markers in the cord blood: erythropoietin, S100 and cardiac troponin-t. Almost 80% of newborns developed neonatal abstinence syndrome (NAS) and two third of them needed morphine medication for it. Maternal smoking over ten cigarettes per day aggravated and benzodiazepine use attenuated NAS. An infant s highest urinary norbuprenorphine concentration during their first 3 days of life correlated with the duration of morphine treatment. The average length of infant s hospital stay was 25 days.

Lyophilized disaccharides – the effect of water during storage

Nearly one fourth of new medicinal molecules are biopharmaceutical (protein, antibody or nucleic acid derivative) based. However, the administration of these compounds is not always that straightforward due to the fragile nature of aforementioned domains in GI-tract. In addition, these molecules often exhibit poor bioavailability when administered orally. As a result, parenteral administration is commonly preferred. In addition, shelf-life of these molecules in aqueous environments is poor, unless stored in low temperatures. Another approach is to bring these molecules to anhydrous form via lyophilization resulting in enhanced stability during storage. Proteins cannot most commonly be freeze dried by themselves so some kind of excipients are nearly always necessary. Disaccharides are commonly utilized excipients in freeze-dried formulations since they provide a rigid glassy matrix to maintain the native conformation of the protein domain. They also act as "sink"-agents, which basically mean that they can absorb some moisture from the environment and still help to protect the API itself to retain its activity and therefore offer a way to robust formulation. The aim of the present study was to investigate how four amorphous disaccharides (cellobiose, melibiose, sucrose and trehalose) behave when they are brought to different relative humidity levels. At first, solutions of each disaccharide were prepared, filled into scintillation vials and freeze dried. Initial information on how the moisture induced transformations take place, the lyophilized amorphous disaccharide cakes were placed in vacuum desiccators containing different relative humidity levels for defined period, after which selected analyzing methods were utilized to further examine the occurred transformations. Affinity to crystallization, water sorption of the disaccharides, the effect of moisture on glass transition and crystallization temperature were studied. In addition FT-IR microscopy was utilized to map the moisture distribution on a piece of lyophilized cake. Observations made during the experiments backed up the data mentioned in a previous study: melibiose and trehalose were shown to be superior over sucrose and cellobiose what comes to the ability to withstand elevated humidity and temperature, and to avoid crystallization with pharmaceutically relevant moisture contents. The difference was made evident with every utilized analyzing method. In addition, melibiose showed interesting anomalies during DVS runs, which were absent with other amorphous disaccharides. Particularly fascinating was the observation made with polarized light microscope, which revealed a possible small-scale crystallization that cannot be observed with XRPD. As a result, a suggestion can safely be made that a robust formulation is most likely obtained by utilizing either melibiose or trehalose as a stabilizing agent for biopharmaceutical freeze-dried formulations. On the other hand, more experiments should be conducted to obtain more accurate information on why these disaccharides have better tolerance for elevating humidities than others.

Suomussalmen varhaisproterotsooisten diabaasien mineralogia tektonisessa tulkinnassa

The object of this research is to study the mineralogy of the diabase dykes in Suomussalmi and the relevance of the mineralogy to tectonic events, specifically large block movements in the Archaean crust. Sharp tectonic lines separate two anomalies in the dyke swarms, shown on a geomagnetic map as positive anomalies. In one of these areas, the Toravaara anomaly, the diabases seem to contain pyroxenes as a main component. Outside the Toravaara anomaly hornblende is the main ferromagnesian mineral in diabases. The aim of this paper is to research the differences in the diabases inside and outside the anomalies and interpret the processes that formed the anomalies. The data for this sudy consist of field observations, 120 thin sections, 334 electron microprobe analyses, 19 whole-rock chemical analyses, a U-Pb age analysis and geomagnetic low-altitude aerial survey maps. The methods are interpretation of field observations, chemical analyses, microprobe analyses of single minerals and radiometric age determination, microscopic studies of the thin sections, geothermometers and geobarometers. On the basis of field observations and petrographic studies the diabases in the area are divided into pyroxene diabases, hornblende diabases and the Lohisärkkä porphyritic dyke swarm. Hornblende diabases are found in the entire study area, while the pyroxene diabases concentrate on the area of the Toravaara geomagnetic anomaly. The Lohisärkkä swarm transects the whole area as a thin line from east to west. The diabases are fairly homogenous both chemically and by mineral composition. The few exceptions are part of rarer older swarms or are significantly altered. The Lohisärkkä dyke swarm was dated as 2,21 Ga old, significantly older than the most common 1,98 Ga swarm in the area. The geothermometers applied showed that the diabases on the Toravaara anomaly were stabilized at a much higher temperature than the dykes outside the anomaly. The geobarometers showed the pyroxenes to have crystallized at varying depths. The research showed the Toravaara anomaly to have formed by a vertical block movement, and the fault on its west side to have a total lateral transfer of only a few kilometers. The formation of the second anomaly was also interpreted to be tectonic in nature. In addition, the results of the geothermobarometry uncovered necessary conditions for the study of diabase emplacement depth: the minerals for the study must be chosen by minimum crystallization depth, and a geobarometer capable of determining the magmatic temperature must be used. In addition, it would be more suitable to conduct this kind of study in an area where the dykes are more exposed.