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PubMedDate not supplied

Brucella melitensis infection in sheep: present and future.

Sheep brucellosis, a zoonosis mainly due to B. melitensis (biovar 1, 2 or 3), remains widespread world-wide. Pathologically and epidemiologically, the disease is very similar to B. abortus infection in cattle. The live B. melitensis Rev 1 strain is currently considered as the best vaccine available for the control of sheep brucellosis, especially when used at the standard dose by the conjunctival route. Used exhaustively in whole-flock vaccination programmes, it induces a great decrease in the prevalence in both sheep and human populations. The expensive test-and-slaughter strategy should be restricted to the lowest infected areas. Whenever possible, Brucella spp. should be isolated by culture using adequate selective media from uterine discharges, aborted fetuses, udder secretions or selected tissues, such as lymph nodes, testes or epididymides. Species and biovar identification is routinely based on cultural criteria, on lysis by phages and on simple biochemical and serological tests. The recently developed polymerase chain reaction methods provide additional means of detection and identification. Despite the high degree of DNA homology within the genus Brucella, several methods, including PCR-RFLP and Southern blot, have been developed which allow, to a certain extent, the differentiation between Brucella species and some of their biovars. While several ELISA tests have been developed recently, the rose bengal plate agglutination and complement fixation tests, based on the detection of anti-S-LPS antibody, are still recommended for screening flocks and individuals. However, these tests sometimes lack specificity or sensitivity. For pooled samples, there are no useful tests such as the milk ring test in cattle. The brucellin allergic skin test can be used as a screening or complementary test in unvaccinated flocks, provided that a purified, lipopolysaccharide (LPS)-free and standardized antigen preparation is used.

Animals↗
PubMed2003

Quality of life following early medical or surgical abortion.

Short-term quality of life following abortion is poorly characterized. We conducted a prospective cohort study to evaluate 97 U.S. women who selected either medical abortion with mifepristone and misoprostol or surgical abortion up to 9 weeks gestation in a private-practice setting. Women choosing medical abortion and those choosing surgical abortion with local anesthesia were similar on most baseline characteristics. Eighty-five participants completed a standardized quality of life assessments three times over 1 month. The 30-item questionnaire yielded scores for global health, emotional, social, cognitive and physical functioning and for specific symptom scales. At baseline, participants reported many symptoms and functional limitations during the previous week. Subjects in both treatment groups experienced clinically and statistically significant improvements on all scales at follow-up. Surgical abortion patients had worse scores on three of five function scales and several symptom scales at baseline compared to medical abortion patients. Differences in baseline scores between the medical and surgical abortion patients disappeared during follow-up. A surprising finding was that partner knowledge of the pregnancy at the time the abortion appointment was made was associated with significantly worse scores on most of the function and symptom scales. These results provide substantial reassurance that women undergoing abortion experience a marked improvement in their quality of life after the abortion. Women choosing medical or surgical abortion report very similar quality of life improvements.

Abortifacient Agents↗
PubMed2002

Transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion.

OBJECTIVE: To evaluate the role of transvaginal color Doppler ultrasonography in the management of first-trimester spontaneous abortion, clinically thought to be complete. STUDY DESIGN: A prospective interventional non-randomized study was performed in a tertiary care University hospital. Sixty-two women with suspected first-trimester spontaneous abortion, clinically thought to be complete were included in the study. All women were evaluated on admission by transvaginal color Doppler ultrasonography. The amount of blood flow within the myometrium or in the endometrium-myometrium interface was assessed. Those women with suspected retained tissue on color Doppler were scheduled to undergo dilatation and curettage (D&C). Those patients with no suspected retained tissue on color Doppler were scheduled for expectant management. RESULTS: Eighteen women had suspected retained tissue and 44 women did not. A total of 16 out of 18 (88.9%) patients had retained trophoblastic tissue confirmed on histopathologic analysis. There were two false negative cases. Outcome of all patients managed expectantly was optimal with no complications. CONCLUSIONS: Transvaginal color Doppler ultrasonography is useful to detect or to rule out the presence of retained trophoblastic tissue after first-trimester spontaneous abortion and to select patients for expectant management.

Abortion, Spontaneous↗
PubMedDate not supplied

Maternal occupation: effects on spontaneous abortions and malformations.

The epidemiology of spontaneous abortion is described and the literature relating selected occupations to spontaneous abortion and to malformations is reviewed. A study on the effects of anesthetic gases on pregnancy outcome is presented to demonstrate approaches to research.

Abnormalities, Drug-Induced↗
PubMed1979

Efficacy and acceptability of intravenously administered sulprostone, a tissue-selective prostaglandin-E2 derivative, for induction of first-trimester abortion.

The abortifacient effect of a new tissue-selective prostaglandin E2-derivative, sulprostone, administered intravenously, has been investigated in 166 women in the the first trimester of pregnancy. Four different dose schedules (1.7 mcg/min for 5 or 10 hour--total dose 500 mcg or 1000 mcg, 2.8 mcg/min and 4.1 mcg/min for 6 hours--total dose 1000 mcg and 1500 mcg) have been evaluated. No absolute failures occurred and no severe complications or side-effects were recorded. Best results (high abortifacient efficacy and low systemic side-effects) were obtained by infusing 1000 mcg sulprostone in appr. 10 h. Our study indicates that sulprostone appears to have a high degree of acceptability.

Abortifacient Agents↗
PubMed1990

Effects of ultrasound, shortwaves, and physical exertion on pregnancy outcome in physiotherapists.

STUDY OBJECTIVE: The aim of the study was to investigate whether occupational exposure among physiotherapists is associated with spontaneous abortion or congenital malformation in the offspring. DESIGN: The study was a retrospective nested case-control study, where the pregnancy outcome data were based on the medical registers. SETTING: All registered physiotherapists in Finland who had become pregnant during the study period were included in the study. SUBJECTS: Cases were defined as women who had been treated for spontaneous abortion during 1973-1983 or had delivered a malformed child during 1973-1982. One pregnancy per woman was randomly selected for the study. Three age matched (+/- 18 months) controls were selected for each abortion case and five for each malformation case. The final study population was 204 cases and 483 controls in the spontaneous abortion study, and 46 cases and 187 controls in the congenital malformation study. MEASUREMENTS AND MAIN RESULTS: Exposure information was collected by mailed questionnaires from 1329 women. The response rate was 92% in the spontaneous abortion study, and 89% in the congenital malformation study. Heavy lifting (including patient transfers) was associated significantly with spontaneous abortion. Exposure to ultrasound and shortwaves showed about threefold odds ratios for spontaneous abortions occurring after the 10th week of gestation but in analysis where potential confounding variables were controlled, neither reached statistical significance. Deep heat therapies together, and shortwaves alone, were associated significantly with congenital malformations, but the increase was found in the lower exposure category only. From the potential confounding variables, previous abortion (spontaneous or induced) was associated significantly with spontaneous abortion, and febrile disease in early pregnancy was associated with congenital malformation. CONCLUSION: Physical exertion during early pregnancy seems to be a risk factor for spontaneous abortion. The findings raise suspicion of the potential harmful effect of shortwaves and ultrasound on the pregnancy, but no firm conclusion can be drawn on the bases of these results alone.

Abortion, Spontaneous↗
PubMed1986

An epidemiological study of work with video screens and pregnancy outcome: II. A case-control study.

A case-control study on work with video screen equipment during pregnancy has been made for three cohorts of women, identified with the aid of occupational codes in the census, linked to the Medical Birth Registry and a registry containing information on women hospitalized for spontaneous abortion. Five hundred and twenty-two cases were selected (women with spontaneous abortions or women who had infants that died, had severe malformations, or had a birth-weight below 1,500 g) and 1,032 controls (women who had infants without any of these characteristics) taken from the same age stratum as the cases. All pregnancies had occurred in 1980-81. Questionnaires were mailed to the women asking for information on their work situation, including questions about work with video screen equipment. Fifty-eight women were excluded for various reasons. Response rate was 93%--lower (89%) among women with spontaneous abortions than among women who gave birth (95%). As stress and smoking were associated with video screen work, the effect of video screen work was analyzed after stratification for stress and smoking--no statistically significant effect of video screen work was seen but odds ratios were above 1. Crude odds ratios for video screen work were significantly elevated and showed a dose-dependent effect. This finding is discussed from the point of view of biases in the study: selective non-responding, recall bias, geographical variability, and lack of information on women who had induced abortions. Using questionnaire data for exposure rates in the populations studied, an estimate of the effect greater than or equal to 10 hr weekly work with video screens on spontaneous abortion rate was made. The point estimate was 1.04 with a 95% confidence interval of 0.9-1.2. Analysis of 44 infants with birth defects whose mothers had worked more than 10 hr/week with video screen equipment compared to 30 infants with birth defects whose mothers had not used such equipment in early pregnancy showed no signs of specificity in the type of birth defect.

Abortion, Spontaneous↗
PubMed2002

Abortion and neonaticide: ethics, practice, and policy in four nations.

Abortion, particularly later-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the US, on the other hand, later-term abortion is severely restricted, while treatment to newborns may be withdrawn. Policy in the UK and Denmark bridges some of these gaps with liberal abortion and neonatal policy. Disparate policy within and between nations creates practical and ethical difficulties. Practice diverges from policy as many practitioners find it difficult to adhere to official policy. Ethically, it is difficult to entirely justify perinatal policy in these nations. In each nation, there are elements of ethically sound policy, while other aspects cannot be defended. Ethical policy hinges on two underlying normative issues: the question of fetal/newborn status and the morality of killing and letting die. While each issue has been the subject of extensive debate, there are firm ethical norms that should serve as the basis for coherent and consistent perinatal policy. These include 1) a grant of full moral and legal status to the newborn but only partial moral and legal status to the late-term fetus 2) a general prohibition against feticide unless to save the life of the mother or prevent the birth of a fetus facing certain death or severe pain or suffering and 3) a general endorsement of neonaticide subject to a parent's assessment of the newborn's interest broadly defined to consider physical harm as well as social, psychological and or financial harm to related third parties. Policies in each of the nations surveyed diverging from these norms should be the subject of public discourse and, where possible, legislative reform.

Abortion, Eugenic↗
PubMed1981

Protein synthesis in Vero cells abortively infected with influenza B virus.

Growth of influenza B virus was found to be greatly restricted in Vero cells compared with that in MDCK cells. The analysis of protein synthesis in infected cells showed that the synthesis of M protein is selectively inhibited in abortive infection. Cell fractionation experiments demonstrated that the viral glycoproteins, HA and NA, migrate from rough membranes via smooth membranes to plasma membranes in abortive as well as in productive cells. These results suggest that intracellular migration of influenza B virus glycoproteins occurs independently of the synthesis of M protein although M protein synthesis appears to be required for the formation of virus particles.

Animals↗
PubMed1986

[Importance of the marriage structure in predicting abortion].

Examination of randomly selected pregnant women of the Kharkov city showed that the structure of marriage had undergone considerable changes during two successive generations. The number of endogamous marriages decreased, the percentage of marriages between persons of different nationalities being increased, which adequately reflects social-demographic processes taking place currently in all human populations. Judging by the data obtained, these changes in percentage of exogamous marriages do not considerably influence the probability of pregnancy failure which can be accounted for disturbed foeto-maternal immunological interrelations. No correlations between immunological indices and the degree of heterozygosity in women and the structure of marriages was demonstrated. The percentage of married couples with tainted heredity (spontaneous abortions, still-birth) was considerably higher among women with habitual pregnancy failure, which may testify to a certain role of hereditary predisposition to immune failure.

Abortion, Habitual↗
PubMed1990

Birth-weight of newborns to Chinese women subsequent to a previous abortion.

The mean birth-weight of firstborns of women was significantly higher when there was a previous abortion. The increase was 73.5 and 119.4 g in newborns of women with an induced and a spontaneous abortion respectively. This trend of significant increased birth-weight among firstborns of women with either a previous induced or spontaneous abortion continued for male infants, in recent migrants, and in subjects aged 20-24 and 30-34 years. Stepwise logistic regression analyses showed that a history of an induced or a spontaneous abortion increased the birth-weight of the firstborns, while short maternal stature and female newborn were associated with decreased birth-weight. For low birth-weight, a previous abortion was not selected into the regression models but short maternal stature and female newborns continue to contribute to low birth-weight. Prematurity and mean gestation were found not to be associated with previous abortion using logistic regression analyses.

Abortion, Induced↗
PubMed1992

Emergency treatment of headache.

The first approach in the emergency treatment of headache is the use of abortive measures in an attempt to forestall progression of early signs and symptoms. Abortive measures include analgesics, antiemetics, and anxiolytics; nonsteroidal anti-inflammatory drugs; ergots, generally preceded by administration of an antiemetic; conservative use of corticosteroids; major tranquilizers; and even narcotics (in certain extreme and selective situations). If abortive measures fail, IM or IV administration of dihydroergotamine mesylate, preceded by promethazine (IM) or metoclopramide (IM or IV) and followed by dexamethasone (IM or IV), is an effective emergency procedure. Every patient seeking care for headache from an emergency department should be instructed on how and where to obtain definitive follow-up and long-term treatment.

Emergencies↗
PubMed2004

The fgl2 prothrombinase/fibroleukin gene is required for lipopolysaccharide-triggered abortions and for normal mouse reproduction.

Increased fgl2 prothrombinase activity in maternal decidua and fetal trophoblasts may trigger abortions by proinflammatory cytokines induced by bacterial lipopolysaccharide (LPS) in mice and is implicated in human recurrent miscarriages and pre-eclampsia. Defining the physiological and pathological role of the fgl2/fibroleukin gene required an fgl2-knockout mouse and data on normal pattern of fgl2 expression during pregnancy. Expression of fgl2 protein was determined by immunostaining with specific antibody. Fgl2 knockout mice were generated and typed by PCR for presence of the altered gene. Immunostaining of timed CBAxDBA/2 mouse matings in a low-abortion-rate colony showed a distinct pattern of development of fgl2 protein expression in maternal decidua, and in embryonic tissues in early pregnancy. Outbred (mixed background) heterozygous fgl2 +/-x+/- matings with a similar low abortion rate showed selective occult loss of both +/- and, to a greater extent, -/- embryos prior to gestation day 11.5, in association with haemorrhage at the anti-mesometrial pole of fgl2-deficient embryo. LPS injected on day 6.5 caused classical abortions at mid-pregnancy in fgl2 +/+x+/+ matings, but not -/-x-/- matings. Physiological expression of fgl2 in fetal trophoblast may prevent occult loss in early pregnancy, along with other coagulation factors, but fgl2 expression is required for LPS to induce abortion pathology.

Abortion, Spontaneous↗
PubMed1998

Somatic hypermutation of immunoglobulin variable region genes: focus on follicular lymphoma and multiple myeloma.

Analysis of the rearranged immunoglobulin variable region gene hypermutation has provided important information concerning the clonal history and ontogenetic origin of various B-cell lymphoproliferative disorders. Under the selective pressure of antigen, mutational events in immunoglobulin genes will fine tune survival of B-cell clones bearing immunoglobulin with high affinity for antigen. Our studies aimed at analyzing neoplastic disorders originating from germinal and post-germinal center B-cells: follicular lymphoma and multiple myeloma, respectively. Despite the already acknowledged evidence for a selectable distribution of mutations within the clonal immunoglobulin variable heavy chain genes, very little is known about the contribution of light chains in the process of antigen selection. In follicular lymphoma, a more limited pattern of somatic mutation with less evidence of antigen selection was observed in variable kappa light chain genes (40%) than in their partner heavy chain genes (80%). In myeloma, hypermutation of variable light chain genes, with a distribution suggestive of antigen selection, was frequently observed. Based on these data and recent reports it appears that the light chain expressed by the clonogenic myeloma B-cells plays a pivotal role in the antigen selection process. Additionally, abortive kappa light chain variable region genes in lambda-expressing myelomas carried a significant number of somatic mutations indicating that the cell of origin is open to the hypermutation machinery at that particular developmental stage irrespective of antigen selection.

Amino Acid Sequence↗
PubMed2000

Correlation of prenatal clinical findings with those observed in fetal autopsies: pathological approach.

Our objective was to present a comprehensive description of the clinicopathological findings of 173 abortions, including 121 therapeutic and 52 spontaneous ones in the period between 1992 and 1998. In all of these fetuses pathological examination was carried out. It was complemented when indicated by immunohistochemistry, in situ hybridization, flow cytometry, and X-ray examination. In the 121 therapeutic abortions the distribution of malformations was: 45 central nervous system anomalies (37%), 12 genitourinary anomalies (10%), 25 gastrointestinal anomalies (21%), two respiratory system anomalies (1.65%), eight cardiac anomalies (6.6%) and 28 other anomalies (17.2%) as revealed by autopsy. From the clinically selected 52 spontaneous abortions, major malformations were seen in 15/52 cases. With the comparison of the pathological and clinical findings in 121 therapeutic abortions, the percentage of cases with correct clinical designation and no missed anomalies amounted for 49%. However in 51% additional or different lethal, severe, or major malformations were revealed or excluded by fetopathological examinations. In 4% the clinical observation and diagnosis were modified, but without implications for the therapeutic termination of pregnancy. The clinical indication could not be supported in another 3% of the cases.

Abortion, Spontaneous↗