To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy.
Systematic review of relevant articles published between January 1985 and June 2007.
...It is highly probable that intrauterine first-trimester valproate (VPA) exposure has higher risk of major congenital malformations (MCMs) compared to carbamazepine and possible compared to phenytoin or lamotrigine. Compared to untreated WWE, it is probable that VPA as part of polytherapy and possible that VPA as monotherapy contribute to the development of MCMs. It is probable that antiepileptic drug (AED) polytherapy as compared to monotherapy regimens contributes to the development of MCMs and to reduced cognitive outcomes. For monotherapy, intrauterine exposure to VPA probably reduces cognitive outcomes. Further, monotherapy exposure to phenytoin or phenobarbital possibly reduces cognitive outcomes. Neonates of WWE taking AEDs probably have an increased risk of being small for gestational age and possibly have an increased risk of a 1-minute Apgar score of <7.
If possible, avoidance of valproate (VPA) and antiepileptic drug (AED) polytherapy during the first trimester of pregnancy should be considered to decrease the risk of major congenital malformations (Level B). If possible, avoidance of VPA and AED polytherapy throughout pregnancy should be considered to prevent reduced cognitive outcomes (Level B). If possible, avoidance of phenytoin and phenobarbital during pregnancy may be considered to prevent reduced cognitive outcomes (Level C). Pregnancy risk stratification should reflect that the offspring of women with epilepsy taking AEDs are probably at increased risk for being small for gestational age (Level B) and possibly at increased risk of 1-minute Apgar scores of <7 (Level C).
To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy, including preconceptional folic acid use, prenatal vitamin K use, risk of hemorrhagic ...disease of the newborn, clinical implications of placental and breast milk transfer of antiepileptic drugs (AEDs), risks of breastfeeding, and change in AED levels during pregnancy.
A 20-member committee evaluated the available evidence based on a structured literature review and classification of relevant articles published between 1985 and October 2007.
Preconceptional folic acid supplementation is possibly effective in preventing major congenital malformations in the newborns of WWE taking AEDs. There is inadequate evidence to determine if the newborns of WWE taking AEDs have a substantially increased risk of hemorrhagic complications. Primidone and levetiracetam probably transfer into breast milk in amounts that may be clinically important. Valproate, phenobarbital, phenytoin, and carbamazepine probably are not transferred into breast milk in clinically important amounts. Pregnancy probably causes an increase in the clearance and a decrease in the concentration of lamotrigine, phenytoin, and to a lesser extent carbamazepine, and possibly decreases the level of levetiracetam and the active oxcarbazepine metabolite, the monohydroxy derivative.
Supplementing women with epilepsy with at least 0.4 mg of folic acid before they become pregnant may be considered (Level C). Monitoring of lamotrigine, carbamazepine, and phenytoin levels during pregnancy should be considered (Level B) and monitoring of levetiracetam and oxcarbazepine (as monohydroxy derivative) levels may be considered (Level C). A paucity of evidence limited the strength of many recommendations.
To reassess the evidence for management issues related to the care of women with epilepsy (WWE) during pregnancy, including the risk of pregnancy complications or other medical problems during ...pregnancy in WWE compared to other women, change in seizure frequency, the risk of status epilepticus, and the rate of remaining seizure-free during pregnancy.
A 20-member committee including general neurologists, epileptologists, and doctors in pharmacy evaluated the available evidence based on a structured literature review and classification of relevant articles published between 1985 and February 2008.
For WWE taking antiepileptic drugs, there is probably no substantially increased risk (greater than two times expected) of cesarean delivery or late pregnancy bleeding, and probably no moderately increased risk (greater than 1.5 times expected) of premature contractions or premature labor and delivery. There is possibly a substantially increased risk of premature contractions and premature labor and delivery during pregnancy for WWE who smoke. Seizure freedom for at least 9 months prior to pregnancy is probably associated with a high likelihood (84%-92%) of remaining seizure-free during pregnancy.
Women with epilepsy (WWE) should be counseled that seizure freedom for at least 9 months prior to pregnancy is probably associated with a high rate (84%-92%) of remaining seizure-free during pregnancy (Level B). However, WWE who smoke should be counseled that they possibly have a substantially increased risk of premature contractions and premature labor and delivery during pregnancy (Level C).
Abstract In patients with cystic fibrosis (CF) lung damage secondary to chronic infection is the main cause of death. Treatment of lung disease to reduce the impact of infection, inflammation and ...subsequent lung injury is therefore of major importance. Here we discuss the present status of antibiotic therapy for the major pathogens in CF airways, including prophylaxis against infection, eradication of early infection, suppression of chronic infection, and the treatment of infective exacerbations. We outline measures to optimize maintenance treatment for infection in the light of novel antibiotic drug formulations. We discuss new developments in culture-independent microbiological diagnostic techniques and the use of tools for monitoring the success of antibiotic treatment courses. Finally, cost-effectiveness analyses for antibiotic treatment in CF patients are discussed.
Complexity involved in the transport of soils and the restrictive legislation for the area makes on-site bioremediation the strategy of choice to reduce hydrocarbons contamination in Antarctica. The ...effect of biostimulation (with N and P) and bioaugmentation (with two bacterial consortia and a mix of bacterial strains) was analysed by using microcosms set up on metal trays containing 2·5 kg of contaminated soil from Marambio Station. At the end of the assay (45 days), all biostimulated systems showed significant increases in total heterotrophic aerobic and hydrocarbon-degrading bacterial counts. However, no differences were detected between bioaugmented and nonbioaugmented systems, except for J13 system which seemed to exert a negative effect on the natural bacterial flora. Hydrocarbons removal efficiencies agreed with changes in bacterial counts reaching 86 and 81% in M10 (bioaugmented) and CC (biostimulated only) systems. Results confirmed the feasibility of the application of bioremediation strategies to reduce hydrocarbon contamination in Antarctic soils and showed that, when soils are chronically contaminated, biostimulation is the best option. Bioaugmentation with hydrocarbon-degrading bacteria at numbers comparable to the total heterotrophic aerobic counts showed by the natural microflora did not improve the process and showed that they would turn the procedure unnecessarily more complex.
Increasing evidence exists that maternal obesity (MO) and overnutrition during pregnancy and lactation have long-lasting consequences for progeny metabolism, cardiovascular and endocrine function. ...Data on effects of MO on offspring reproduction are limited. We hypothesized that MO during pregnancy and lactation in founder F(0) rat mothers would increase testicular and sperm oxidative stress (OS) and adversely impact male fertility in their F(1) offspring.
We induced pre-pregnancy MO by feeding F(0) females a high-fat diet from weaning through pregnancy and lactation. After weaning, all F(1) rats ate control (C) diet. We determined serum testosterone, malondialdehyde (MDA), reactive oxygen species (ROS) and superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity in F(1) testes and sperm at postnatal days (PNDs) 110, 450 and 650.
At PNDs 450 and 650, MO offspring had lower luteinizing hormone while testosterone levels were lower at all ages. Testicular MDA and ROS concentrations and SOD and GPx activity were higher in MO F(1) at all ages. Nitrotyrosine immunostaining was higher at all ages in MO F(1) testes than C F(1). At PNDs 450 and 650, MO F(1) spermatozoa showed higher MDA concentrations and lower SOD and GPx activity with reduced sperm concentration, viability and motility, and more sperm abnormalities. Fertility rate was not affected at PND 110 but was lower in MO F(1) at PNDs 450 and 650.
We conclude that MO during pregnancy and lactation increases F(1) testicular and sperm OS leading to premature aging of reproductive capacity.
The super Pioneering High Energy Nuclear Interaction eXperiment (sPHENIX) at the Relativistic Heavy Ion Collider will perform high-precision measurements of jets and heavy flavor observables for a ...wide selection of nuclear collision systems, elucidating the microscopic nature of strongly interacting matter ranging from nucleons to the strongly coupled quark-gluon plasma. A prototype of the sPHENIX calorimeter system was tested at the Fermilab Test Beam Facility as experiment T-1044 in the spring of 2016. The electromagnetic calorimeter (EMCal) prototype is composed of scintillating fibers embedded in a mixture of tungsten powder and epoxy. The hadronic calorimeter (HCal) prototype is composed of tilted steel plates alternating with the plastic scintillator. Results of the test beam reveal the energy resolution for electrons in the EMCal is <inline-formula> <tex-math notation="LaTeX">2.8\%\oplus 15.5\%/\sqrt {E} </tex-math></inline-formula> and the energy resolution for hadrons in the combined EMCal plus HCal system is <inline-formula> <tex-math notation="LaTeX">13.5\%\oplus 64.9\%/\sqrt {E} </tex-math></inline-formula>. These results demonstrate that the performance of the proposed calorimeter system satisfies the sPHENIX specifications.
In Antarctica, the environmental conditions and the restrictions imposed by the Antarctic Treaty prevent inoculation with foreign bacteria. Therefore, our aim was to investigate native bacterial ...consortia which might serve to design bacterial formulas suitable for soil bioremediation processes at cold temperatures. Two bacterial consortia, M10 and J13, were isolated from diesel contaminated Antarctic soils. Their ability to use hydrocarbons was evaluated in vitro and by the detection of three catabolic genes (alkB, nahAc, xylE). Both consortia showed similar 16S rRNA gene profiles, suggesting the presence of the same phylotypes. Total 16S rDNA was cloned from M10 grown on diesel. Sixty clones were screened, grouped by restriction profiles of PCR-amplified inserts and sequenced. T-RFLP (Terminal-Restriction-Fragment-Length-Polymorphism) of clones showed that all phylotypes from the entire consortia were recovered. A culture-dependent approach was used to isolate M10 components able to utilise aliphatic and aromatic hydrocarbons. Pseudomonas, Stenotrophomonas, Pedobacter and Brevundimonas genera were detected. The combination of dependent and independent culture methods allowed elucidating the taxonomic composition of these native bacterial consortia. Further work will assess whether combining the isolates obtained as a defined mixed culture can enhance bioremediation of contaminated soils.
► Two bacterial consortia degrade a broad range of aromatic and aliphatic hydrocarbons. ► Both Antarctic consortia are dominated by Pseudomonas and Stenotrophomonas. ► Combination of isolates allows tailored microbial formulas for bioaugmentation. ► Inoculation can accelerate remediation of pristine soils impacted with hydrocarbons. ► Use of native bacteria complies with non-introduction of alien organisms in Antarctica.
The bacterial and fungal community involved in ambrosia beetle fungiculture remains poorly studied compared to the famous fungus-farming ants and termites. Here we studied microbial community ...dynamics of laboratory nests, adults, and brood during the life cycle of the sugarcane shot hole borer,
We identified a total of 40 fungal and 428 bacterial operational taxonomic units (OTUs), from which only five fungi (a
fungus and four ascomycete yeasts) and four bacterial genera (
,
,
, and
) can be considered the core community playing the most relevant symbiotic role. Both the fungal and bacterial populations varied significantly during the beetle's life cycle. While the ascomycete yeasts were the main colonizers of the gallery early on, the
and other filamentous fungi appeared after day 10, at the time when larval hatching happened. Regarding bacteria,
and
dominated overall but decreased in foundresses and brood with age. Finally, inferred analyses of the putative metabolic capabilities of the bacterial microbiome revealed that they are involved in (i) degradation of fungal and plant polymers, (ii) fixation of atmospheric nitrogen, and (iii) essential amino acid, cofactor, and vitamin provisioning. Overall, our results suggest that yeasts and bacteria are more strongly involved in supporting the beetle-fungus farming symbiosis than previously thought.
Ambrosia beetles farm their own food fungi within tunnel systems in wood and are among the three insect lineages performing agriculture (the others are fungus-farming ants and termites). In ambrosia beetles, primary ambrosia fungus cultivars have been regarded essential, whereas other microbes have been more or less ignored. Our KEGG analyses suggest so far unknown roles of yeasts and bacterial symbionts, by preparing the tunnel walls for the primary ambrosia fungi. This preparation includes enzymatic degradation of wood, essential amino acid production, and nitrogen fixation. The latter is especially exciting because if it turns out to be present
in ambrosia beetles, all farming animals (including humans) are dependent on atmospheric nitrogen fertilization of their crops. As previous internal transcribed spacer (ITS) metabarcoding approaches failed on covering the primary ambrosia fungi, our 18S metabarcoding approach can also serve as a template for future studies on the ambrosia beetle-fungus symbiosis.
The ATLAS detector uses a real time selective triggering system to reduce the high interaction rate from 40 MHz to its data storage capacity of 1 kHz. A hardware first level (L1) trigger limits the ...rate to 100 kHz and a software high level trigger (HLT) selects events for offline analysis. The HLT uses the Regions of Interest (RoIs) identified by L1 and provided by the Region of Interest Builder (RoIB). The current RoIB is a custom VMEbus based system that operated reliably since the first run of the LHC . Since the LHC will reach higher luminosity and ATLAS will increase the complexity and number of L1 triggers, it is desirable to have a more flexible and more operationally maintainable RoIB in the future. In this regard, the functionality of the multi-card VMEbus based RoIB is being migrated to a PC based RoIB with a PCI-Express card. Testing has produced a system that achieved the targeted rate of 100 kHz.
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