Search

Summary: We conducted a narrative review in six areas of obstetric emergencies: category‐1 caesarean section; difficult and failed airway; massive obstetric haemorrhage; hypertensive crisis; emergencies related to neuraxial anaesthesia; and maternal cardiac arrest. These areas represent significant research published within the last five years, with emphasis on large multicentre randomised trials, national or international practice guidelines and recommendations from major professional societies. Key topics discussed: prevention and management of failed neuraxial technique; role of high‐flow nasal oxygenation and choice of neuromuscular drug in obstetric patients; prevention of accidental awareness during general anaesthesia; management of the difficult and failed obstetric airway; current perspectives on the use of tranexamic acid, fibrinogen concentrate and cell salvage; guidance on neuraxial placement in a thrombocytopenic obstetric patient; management of neuraxial drug errors, local anaesthetic systemic toxicity and unusually prolonged neuraxial block regression; and extracorporeal membrane oxygenation use in maternal cardiac arrest. [ABSTRACT FROM AUTHOR]

Background Lesch-Nyhan (LN) syndrome is associated with deficient hypoxanthine-guanine phosphoribosyltransferase (HPRT) activity, but the connection between the aberrant purine metabolism and the neurological symptoms remains largely unknown. The aim of this study was to determine adenosine transporter subtypes affected by HPRT deficiency and by the associated hypoxanthine excess. Materials and methods Nucleoside transporter types (depending on their sodium dependence and 10 µm nitrobenzylthioinosine, NBTI, sensitivity) involved in adenosine transport were compared between peripheral blood lymphocytes (PBL) obtained from nine LN patients, PBLLN (2–21 years) and from nine controls, PBLC (2–23 years) under basal conditions and after 25 µm hypoxanthine incubation. Results We found four types of adenosine transporters in PBL: equilibrative and concentrative transporters that are either sensitive (ENT1 or cs) or insensitive (ENT2 or ci) to NBTI. Adenosine ENT1 uptake was the predominant transporter in both PBLC (55%) and PBLLN (46%). Under basal conditions no significant differences were found in adenosine transport between PBLC and PBLLN. Incubation of PBL with 25 µm hypoxanthine markedly decreased total adenosine transport in both cell types. Hypoxanthine affected equilibrative transport (mainly ENT2 type) in PBLLN and PBLC. Only in PBLC was concentrative transport affected by hypoxanthine. Expressions of human (h) ENT1 and hENT2 mRNA were not significantly modified by hypoxanthine incubation in PBLC. Conclusions This study contributes to further knowledge of the defective adenosine transport found in PBLLN. Increased hypoxanthine levels, similar to those reported in HPRT deficient patients, reduced adenosine uptake by 32% in PBLLN as compared to normal transport. [ABSTRACT FROM AUTHOR]

High-volume foliage sprays of 18 compounds including 13 systemic fungicides in field trials at 4-week intervals did not control vascular-streak dieback (VSD) of cocoa caused by Oncobasidium theobromae in Papua New Guinea. Soil drenching with carbendazim and other systemics was also ineffective, possibly because insufficient carbendazim may have been taken up into the xylem to inhibit the fungus. Stem paints with four systemic fungicides in aqueous formulations were also ineffective, but 4-weekIy stem painting of the hardened bark of young seedlings with 10 g/1 propiconazole in 25%. white oil caused a highly significant reduction in VSD incidence under field conditions. The treatment had no curative effect. Some phytotoxicity was observed but this was not apparent when the concentration of propiconazole was doubled and the treatment interval lengthened to 8 weeks. The ineffectiveness of systemic fungicides as soil drenches and foliage applications was probably due to failure of these compounds to accumulate at the shoot apex where infection occurs. A stable and non-toxic formulation containing surfactants was developed which may improve control by aiding bark penetration by propiconazole or related compounds. [ABSTRACT FROM AUTHOR]

Isolation of clonal cocoa material in screened shade houses for 6 months allows adequate opportunity for detecting vascular-streak dieback caused by Oncobasidium theobromae and in Papua New Guinea a further period of 6 months in intermediate quarantine on an isolated island has been replaced by a similar period in screened houses at a quarantine station in the importing locality. Microscope examination of transverse sections of budwood sticks and pot stalks provides a further very thorough precaution against disease transmission because hyphae of the pathogen are large and easily detected. Hyphae were found within the stalks and placentae of pods from diseased branches but seeds from these germinated normally and there was no evidence of seed transmission. Dipping rubbed seeds in 1 g/l propiconazole plus 5g/l metalxyl caused a small but statistically significant reduction in seeding stem height. However, root length and percentage germination were not affected and this prophylactic seed treatment may be useful in situations where quarantine authorities require additional precautions. [ABSTRACT FROM AUTHOR]

An inoculation technique was developed to assay isolates of entomopathogenic fungi, mainly Metarhizium spp., against the desert locust Schistocerca gregaria. Both sexes can be used and neither feeding nor maintenance of a high humidity is necessary. Assays were routinely conducted at 35% relative humidity and 30°C. The technique uses a dose of 2-5 μl conidial suspension formulated in vegetable oil, which is applied with a micropipette or an automatic applicator beneath the dorsal pronotal shield of an adult locust 7-10 days post-fledging. The speed of kill is dose dependent; at a dose of 3.75 × 105 conidia/g body weight (7.5 × 105 conidia/insect) chosen as a standard, locusts began dying 4 days post application. Several vegetable oils were suitable as diluents for the conidial suspensions, but neem was toxic to the insects. After inoculation, locusts had to be maintained in individual boxes. If inoculated and uninoculated insects were placed in close proximity immediately after inoculation with an oil suspension of conidia, the uninoculated insects succumbed to infection 2-3 days later than the inoculated ones, indicating transfer of inoculum. [ABSTRACT FROM AUTHOR]

Acetylcholine receptor (AChR)-bearing membranes from the BC3H-1 cell lines were injected, without adjuvant, either intrathymically (i.t.) followed by intraperitoneal (i.p.) booster doses, or i.p. alone, into (C57BL × BALB/c) F1 mice. Over 75% of the animals developed serum anti-AChRs which reacted with the cell-line AChR and with normal mouse endplate AChR. The titres were within the lower range of those of myasthenia gravis patients, and some mice showed reduced miniature endplate potential (m.e.p.p.) amplitudes. These results indicate that loss of tolerance to acetylcholine receptors can result from immunization against syngeneic AChR without adjuvant. This approach may provide a useful model for studying mechanisms of autoimmunity against acetylcholine receptor. [ABSTRACT FROM AUTHOR]

Three novel HLA class II alleles, DRB1*08:70, DQA1*01:13 and DQA1*03:01:03, were characterized. [ABSTRACT FROM AUTHOR]

Using the lessons gained from implementing the St Vincent Declaration for Diabetes (1990), this declaration details general goals, 5 years targets, performance and outcome measures for the detection and management of early psychosis. Its successful implementation requires integrated partnerships working locally, nationally and internationally to: [ABSTRACT FROM AUTHOR]

Reports on the discovery of a type of blight disease on Buxus in Great Britain caused by the fungus Cylindrocladium. Geographic distribution of the disease; Symptoms; Comparison of internal transcribed spacer gene sequence with other GenBank sequences.