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.

Development of an LH receptor assay capable of measuring serum LH/CG in a wide variety of species

The development of a radioreceptor assay (RRA) that can measure serum LH in a variety of species and CG in sera and urine of pregnant women and monkeys is reported. Using sheep luteal membrane as the receptor source and I-125-labelled hLH/hCG as the tracer, dose-response (displacement) curves were obtained using hLH or hCG as standard. The addition of LH-free serum (200 mul per tube) had no affect on the standard displacement curve. The assay is simple, requires less than 90 min to complete and provides reproducible results. The sensitivity of the assay was 0.6 ng hLH per tube and the intra- and interassay variations were 9.6 and 9.8, respectively. Sera obtained from male and female bonnet monkeys (Macaca radiata) and monkey pituitary extract showed parallelism to the standard curve. The concentrations of LH measured correlated with the physiological status of the animals. Sera of rats, rabbits, hamsters, guinea-pigs, sheep and humans showed parallelism to the hLH standard curve indicating the viability of the RRA to measure serum LH of different species. Since the receptors recognize LH and CG, detection of pregnancy in monkeys and women was possible using this assay. The sensitivity of the assay for hCG was 8.7 miu per tube. This RRA could be a convenient alternative to the Leydig cell bioassay for obtaining the LH bioactivity profile of sera and biological fluids.

Precarious Pregnancies : Alcohol, drugs and the regulation of risks

Since the 1970s alcohol and drug use by pregnant women has become a target of political, professional and personal concern. The present study focuses on prenatal substance use and the regulation of risks by examining different kinds of societal responses to prenatal alcohol and drug use. The study analyses face-to-face encounters between professionals and service users at a specialised maternity clinic for pregnant women with substance abuse problems, medical and political discourses on the compulsory treatment of pregnant women as a means of FAS prevention and official recommendations on alcohol intake during pregnancy. Moreover, the study addresses the women s perspective by asking how women who have used illicit drugs during pregnancy perceive and rank the dangers linked to drug use. The study consists of five empirical sub-studies and a summary article. Sub-study I was written in collaboration with Dorte Hecksher and Sub-study IV with Riikka Perälä. Theoretically the study builds on the one hand, on the socio-cultural approach to the selection and perception of risks and on the other on governmentality studies which focus on the use of power in contemporary Western societies. The study is based on an ethnographic approach and makes use of the principles of multi-sited ethnography. The empirical sub-studies are based on three different types of qualitative data: ethnographic field notes from a maternity clinic from a period of 7 months, documentary material (medical journals, political documents, health education materials, government reports) and 3) interviews from maternity clinics with clients and members of staff. The study demonstrates that the logic of the regulation of prenatal alcohol use in Finland is characterised by the rise of the foetus , a process in which the urgency of protecting the foetus has gradually gained a more prominent role in the discourses on alcohol-related foetal damage. An increasing unwillingness to accept any kinds of risks when foetal health is at stake is manifested in the public debate on the compulsory treatment of pregnant women with alcohol problems and in the health authorities decision to advise pregnant women to refrain from alcohol use during pregnancy (Sub-studies I and II). Secondly, the study suggests that maternity care professionals have an ambivalent role in their mundane encounters with their pregnant clients: on the one hand professionals focus on the well-being of the foetus, but on the other, they need to take into account the women s needs and agency. The professionals daily encounters with their clients are thus characterised by hybridisation: the simultaneous use of technologies of domination and technologies of agency (Sub-studies III and IV). Finally, the study draws attention to the women s understanding of the risks of illicit drug during pregnancy, and shows that the women s understanding of risk differs from the bio-medical view. The study suggests that when drug-using pregnant women seek professional help they can feel that their moral worth is threatened by professionals negative attitudes which can make service-use challenging.

Efficient syntheses of benzothiazepines as antagonists for the mitochondrial sodium-calcium exchanger: Potential therapeutics for type II diabetes

Type II diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic, and retinal complications. While several drugs are currently prescribed to treat type II diabetes, their efficacy is limited by mechanism-related side effects (weight gain, hypoglycemia, gastrointestinal distress), inadequate efficacy for use as monotherapy, and the development of tolerance to the agents. Consequently, combination therapies are frequently employed to effectively regulate blood glucose levels. We have focused on the mitochondrial sodium-calcium exchanger (mNCE) as a novel target for diabetes drug discovery. We have proposed that inhibition of the mNCE can be used to regulate calcium flux across the mitochondrial membrane, thereby enhancing mitochondrial oxidative metabolism, which in turn enhances glucose-stimulated insulin secretion (GSIS) in the pancreatic beta-cell. In this paper, we report the facile synthesis of benzothiazepines and derivatives by S-alkylation using 2-aminobenzhydrols. The syntheses of other bicyclic analogues based on benzothiazepine, benzothiazecine, benzodiazecine, and benzodiazepine templates are also described. These compounds have been evaluated for their inhibition of mNCE activity, and the results from the structure-activity relationship (SAR) studies are discussed.

Thermodynamics of oxide sulfate melts: The system PbO PbSO4

Activities in the PbO-PbSO4 melts at 1253 K have been measured by emf and gas-equilibration techniques. The activity of PbO was directly obtained from the emf of the solid oxide cell, Pt, Ni-NiO/CaO-ZrO2/Auo.92PbO.08, PbOx-PbSO4(1-x), Ir, Pt for 1.0 >XPbO > 0.6. The melt and the alloy were contained in closed zirconia crucibles. Since the partial pressure of SO2 gas in equilibrium with the melt and alloy was appreciable (>0.08 atm) atXPbO < 0.6, activities at lower PbO concentrations were derived from measurements of the weight gain of pure PbO under controlled gas streans of Ar + SO2 + O2. The partial and integral free energies of mixing at 1253 K were calculated and found to fit a subregular model: ΔGEPbO =X2PbSO4 {-42,450 + 20,000X2PbSO4} J mol-1 ΔGEPbO =X2pbSO {-12,450 - 20,000XPbS} J mol-1 ΔGEpbSOXPbSO4 {-32,450XPbS - 22,450XPbSO4 } J mol-1. The standard free energy of formation of liquid PbSO4 from pure liquid PbO and gaseous SO3 at 1 atm at 1253 K was evaluated as -88.02 (±0.72) kJ mol-1.

Advances in nanomedicines for malaria treatment

Malaria is an infectious disease that mainly affects children and pregnant women from tropical countries. The mortality rate of people infected with malaria per year is enormous and became a public health concern. The main factor that has contributed to the success of malaria proliferation is the increased number of drug resistant parasites. To counteract this trend, research has been done in nanotechnology and nanomedicine, for the development of new biocompatible systems capable of incorporating drugs, lowering the resistance progress, contributing for diagnosis, control and treatment of malaria by target delivery. In this review, we discussed the main problems associated with the spread of malaria and the most recent developments in nanomedicine for anti-malarial drug delivery. (C) 2013 Elsevier B.V. All rights reserved.

Effect of hydrogen on the yielding behavior and shear transformation zone volume in metallic glass ribbons

The effect of hydrogen (H) charging on the shear yield strength (tau(max)) and shear transformation zone volume (Omega) of Ni-Nb-Zr metallic glass ribbons, with varying Zr content, were studied through the first pop-in loads during nanoindentation. Weight gain measurements after H charging and desorption studies were utilized to identify how the total H absorbed during charging is partitioned into mobile and immobile (or trapped) parts. These, in turn, indicate the significant role of H mobility in the amorphous structure on the yielding behavior. In high-Zr alloys, tau(max) increases significantly whereas Omega decreases. In low-Zr alloys, a slight decrease in tau(max) and increase in Omega were noted. These experimental observations are rationalized in terms of the mobility of the absorbed H in the amorphous structure and the possible role of it in the shear transformation zone dynamics during deformation of the metallic glass. (C) 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Selectivity, pulse fishing and endogenous lifespan in Beverton-Holt models

Optimal management in a multi-cohort Beverton-Holt model with any number of age classes and imperfect selectivity is equivalent to finding the optimal fish lifespan by chosen fallow cycles. Optimal policy differs in two main ways from the optimal lifespan rule with perfect selectivity. First, weight gain is valued in terms of the whole population structure. Second, the cost of waiting is the interest rate adjusted for the increase in the pulse length. This point is especially relevant for assessing the role of selectivity. Imperfect selectivity reduces the optimal lifespan and the optimal pulse length. We illustrate our theoretical findings with a numerical example. Results obtained using global numerical methods select the optimal pulse length predicted by the optimal lifespan rule.

Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study

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Growth responses and yield of heterotis (Heterotis niloticus) on artificial diet

The growth responses and yield of Heterotis niloticus on artificial diets of varying protein levels were studied in a bid to assess the implication of feeding Heterotis in intensive fish production venture for a rearing period of 84 days. One hundred and twenty juvenile H.niloticus were fed for 12 weeks on 28%, 31%, 34% and 37% dietary crude protein levels. The fish were reared in 4 concrete tanks stocked at the rate of 10 fish per M super(2) 100,00/hectare). Consequently, the weight gain, food conversion ratio, serum protein and albumin-globulin ratio were determined to assess the growth and state of health of the fish. The yield was appraised through economic considerations of cost of production of fish and diets (feed). The varying crude protein levels significantly influenced mean weight gain, percentage weight gain and food conversion ratio however, the 37% crude protein in diet produced the best growth. The serum protein was highest in fish raised on 31% crude protein diet while the highest value was recorded for albumin-globulin ratio on diet containing 34% crude protein. The yield from treatments 1, 2, 3, and 4 were 114.38 of/84 days 571.9kg/g hect);146.79g/84 days 733.95kg/hect), respectively. However, treatment 3 recorded the highest value for profit index

The effects of supplemental feeds containing different protein: Energy ratios on the growth and survival of Tilapia nilotica (Oreochromis niloticus) in brackishwater ponds

A research was conducted in thirty approximately 100 sq.m earthern ponds of the Brackishwater Aquaculture Centre (BAC), College of Fisheries, University of the Philippines, Leganes Iloilo from November 7, 1982 to March 7, 1983 to evaluate the effects of nine supplemental feeds containing different protein: energy ratios on the growth and survival of Tilapia nilotica in brackishwater ponds. Nine supplemental feeds formulated were with protein levels of 20%, 25%, and 30% each at three energy levels of 3,000 kcals; 3,500 kcals; and 4,000 kcals. There was a control treatment with no feeding so that mean weight gain growth rate, feed conversion rate, and survival were determined. Fish fingerlings were acclimated from 0-29 ppt. salinity before the experiment and 20% of fish in each treatment were sampled after every 30 days. Growth rates were significantly different and increased with increasing energy level at the 30% protein feeds but decreased at high energy levels in the 20% and 25% protein feeds. Feed conversion was significantly different due to interaction between protein and energy levels in the feeds, and was better at the 30:3,500 kcals feeds having a feed conversion of 1.55 g. Survival was not significantly different

Digestibility and nutrient utilization of soybean milk concentrate based diets in Oreochromis niloticus

The digestibility and utilisation of two fresh soybean milk concentrate based diets, two stale soybean milk concentrate based diets and two Fishman based diets serving as control, at optimal (30%) and suboptimal (20%) protein levels were evaluated in Oreochromis niloticus. The diets were as follows: Diet I (control) - fishmeal based diet at 30% crude protein, Diet II (control) Fishman based diet at 20% crude protein, Diet III - fresh soybean milk concentrate based diet at 30% crude protein, Diet IV - fresh soybean milk concentrate based diet at 20%, Diet V - stale soybean milk concentrate based diet at 30% crude protein, Diet VI-stale soybean milk concentrate based diet at 20%. Dry matter digestibility differed not significantly with variation in diets (P:0.05). A significant variation was recorded in the protein, lipid and ash digestibility. Proteins were more digestible at optimum than suboptimum level. Ash digestibility was lowest of all the nutrients. Variations in the utilisation of the diets in terms of weight gain, specific growth rate, food conversion ration, protein efficiency ration and apparent net protein utilization were insignificant (P: 0.05). All diets compared favourably with the standard control diet Diet I. This findings suggest the suitability of stale soybean milk concentrate utilisation as protein supplements in the diets of late fry Oreochromis niloticus

Osasun arloko zientzia psikosozialak

Haur-obesitatea gorputzeko gantz kantitatea gehiegizkoa izateari deritzo. Gaixotasun epidemiko kontsideratu den arren, urtero, prebalentzia goraka doa. Eritasun honek ondorio latzak ekar ditzake, besteak beste, beste hainbat gaixotasun eragin baititzake. Hori dela eta, prebentzioan lan egitea da biderik onena, eta horretarako, haur eta gurasoak arrisku faktoreei buruz informatzea da bide zuzena. Lan honen bitartez, gaixotasun honen prebentziorako suertatu diren interbentzio eraginkorrak aztertu eta horietan erizainaren funtzioa zehaztu nahi dugu. Horretarako, 2010 urteaz geroztik argitaratuta dauden ikerlanetan, eraginkortasuna baieztatuta duten prebentzio-programak bilatu dira Pubmed eta Scopus datu baseak erabilita. Bilaketan, entseiu klinikoak eta berrikuspen sistematikoak kontuan hartu dira eta horietan burutatuko interbentzio eraginkorrak aztertu dira. Behin hori edukita, horietan erizainak duen funtzioa aztertu eta prebentzioan duen garrantzia analizatu da. Horretaz aparte, frogatu gabe dauden interbentzio-programak ere aztertu dira, nahiz eta daturik eraginkortzat eman ez den, erizainak barnebiltzen dituen betebeharrak zehazteko eta prebentzioan duen erabilgarritasuna aztertzeko. Hainbat entseiu kliniko aztertu eta gero, haur-obesitatearen aurkako programak eraginkorrak direla ondorioztatu da. Gainera, erizainak hauetan paper garrantzitsua du, kontrolen segimendua eta obesitatearen inguruko heziketa azaltzen baitu. Honek konfidantza eta segurtasun nahikoa ematen die guraso zein umeei eta obesitatea pairatzeko probabilitatea gutxitzen du. Beraz, heziketa eraginkorra izan dadin eta prebentzioan lan egin ahal izateko, erizainak batez ere eskolako testuinguruan ume eta gurasoei eragiteko dituen gaitasunak jorratu dira. Erizainak, heziketa egokia jasoz gero, aholkuak emateko, ohitura-osasuntsuak sustatzeko, azterketa fisiko zein psikologikoa egiteko, zalantzak argitzeko eta konfidantza bermatzeko gai da.

Comparison of extruded and non-extruded soy meals in the diet of genetically improved mudfish Heterobranchus longifilis juveniles

Raw soybeans were subjected to three different processing methods viz Parboiling, Toasting and Extrusion with an Intra Pro Extruder. The processed soybean meals were thereafter incorporated at equal levels into the diets of genetically improved mudfish Heterobranchus longifilis juveniles. The fish were fed the experimental diets in triplicate at 5% of their body weight for eight weeks. The growth performance and food utilization indices, namely Mean Weight Gain (MWG), Food Conversion Ratio (FCR), Specific Growth Rate (SGR%) and Protein Efficient Ratio (PER), were monitored bi-weekly. The results show that fish fed the control fishmeal diets were highest in growth performance, which was significantly different (P>0.05) from others. Among the fish fed the test diets, those fed toasted soybean had higher MWG, SGR, FCR and PER than juveniles fed the parboiled soybean diet. The juveniles fed the extruded soybean diet recorded the least growth performance. The implication of these results in diet formulation is discussed

Effect of different feeding levels on the production of Heterobranchus bidorsalis in outdoor concrete tanks

Fry of Heterobranchus bidorsalis (mean weight, 0.03g) were fed at 10, 20, 30, 40 or 50% of their body weight (bw)/day in outdoor concrete tanks in New Bussa, Nigeria. The fry attained the highest average weight of 6.66g in 10 weeks when fed at 40% bw/day. Feed conversion ratio ranged from 2.13 to 9.65, the protein efficiency ratio from 1.33 to 5.93. Results indicated that H. bidorsalis are efficient feed converters. Feed intake was significantly different (p<0.05) between the treatments, specific growth rate (SGR), daily growth rate (DGR), production and average weight gain indicated that 40% of fish biomass was the optimum feeding level