Foetal malformations and seizure control: 52 months data of the Australian Pregnancy Registry

The Australian Pregnancy Registry, affiliated European Register of Antiepileptic drugs in Pregnancy (EURAP), recruits informed consenting women with epilepsy on treatment with antiepileptic drugs (AEDs), those untreated, and women on AEDs for other indications. Enrolment is considered prospective if it has occurred before presence or absence of major foetal malformations (FMs) are known, or retrospective, if they had occurred after the birth of infant or detection of major FM. Telephone Interviews are conducted to ascertain pregnancy outcome and collect data about seizures. To date 630 women have been enrolled, with 565 known pregnancy outcomes. Valproate (VPA) above 1100 mg/day was associated with a significantly higher incidence of FMs than other AEDs (P < 0.05). This was independent of other AED use or potentially confounding factors on multivariate analysis (OR = 7.3, P < 0.0001). Lamotrigine (LTG) monotherapy (n = 65), has so far been free of malformations. Although seizure control was not a primary outcome, we noted that more patients on LTG than on VPA required dose adjustments to control seizures. Data indicate an increased risk of FM in women taking VPA in doses > 1100 mg/day compared with other AEDs. The choice of AED for pregnant women with epilepsy requires assessment of balance of risks between teratogenicity and seizure control.

Wonder Down Under: Australian sci-fi 1948-52

Moral guardians, industry protectionists and concerned citizens (each with their own political agendas) had, or many years, lobbied various Ministers of Customs to regulate the offensive material which flooded the local market-the war effectively opened a protectionist climate in which the local publishing industry nourished (Johnson-Woods Pulp Friction). Though westerns dominated at first, science fiction (i.e., futuristic stories, alternative histories, space exploration, time-travel past and future ) soon followed. Within the decaying and yellowed pages, contemporary readers have a glimpse into the culture of the 1950s and, amusing though some of the predictions are, the cultural and social critic gains some understanding of the anxieties and desires of post-World War II Australia.