Maternal Alcohol Consumption During Pregnancy and Physical Outcomes up to 5 Years of Age: A Longitudinal Study

Aim To examine whether alcohol exposure in pregnancy affects weight and head circumference (HC) at birth and 5 years, and whether these effects are independent of cigarette exposure in pregnancy and social disadvantage. Study design The Mater-University Study of Pregnancy (MUSP) involves a prospective cohort of 8556 mothers who were enrolled at first antenatal visit. The quantity and frequency of alcohol consumption in early and late pregnancy and a measure of binge drinking in early pregnancy were recorded. Weight and HC were measured on children seen at birth and at 5 years. Level of cigarette use in early pregnancy and maternal age and level of education and family income were also measured. Results Light and moderate alcohol consumption in early or later pregnancy had no independent effects on weight or HC at birth or 5 years. Binge drinking in early pregnancy was not associated with restricted HC, and there was no effect modification by concurrent cigarette use in early pregnancy. An apparent effect of alcohol in late pregnancy on birth weight was due to confounding by cigarette use, with social risk being an independent predictor. Conclusion Alcohol ingestion up to moderate levels in pregnancy was not associated with deficits in either weight or HC at birth or at 5 years

Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients

Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis patients. 25-hydroxyvitamin D [25(OH)D] was measured in 1108 diabetic haemodialysis patients who participated in the German Diabetes and Dialysis Study and were followed up for a median of 4 years. By Cox regression analyses, we determined hazard ratios (HR) for pre-specified, adjudicated endpoints according to baseline 25(OH)D levels: SCD (n = 146), myocardial infarction (MI, n = 174), stroke (n = 89), cardiovascular events (CVE, n = 414), death due to heart failure (n = 37), fatal infection (n = 111), and all-cause mortality (n = 545). Patients had a mean age of 66 +/- 8 years (54% male) and median 25(OH)D of 39 nmol/L (interquartile range: 28-55). Patients with severe vitamin D deficiency [25(OH)D of 75 nmol/L [HR: 2.99, 95% confidence interval (CI): 1.39-6.40]. Furthermore, CVE and all-cause mortality were strongly increased (HR: 1.78, 95% CI: 1.18-2.69, and HR: 1.74, 95% CI: 1.22-2.47, respectively), all persisting in multivariate models. There were borderline non-significant associations with stroke and fatal infection while MI and deaths due to heart failure were not meaningfully affected. Severe vitamin D deficiency was strongly associated with SCD, CVE, and mortality, and there were borderline associations with stroke and fatal infection. Whether vitamin D supplementation decreases adverse outcomes requires further evaluation.Clinical epidemiolog

Novel iodinated tracers, MIBG and BMIPP, for nuclear cardiology

With the rapid growth of molecular biology, in vivo imaging of such molecular process (i.e., molecular imaging) has been well developed. The molecular imaging has been focused on justifying advanced treatments and for assessing the treatment effects. Most of molecular imaging has been developed using PET camera and suitable PET radiopharmaceuticals. However, this technique cannot be widely available and we need alternative approach. 123I-labeled compounds have been also suitable for molecular imaging using single-photon computed tomography (SPECT) 123I-labeled meta-iodobenzylguanidine (MIBG) has been used for assessing severity of heart failure and prognosis. In addition, it has a potential role to predict fatal arrhythmia, particularly for those who had and are planned to receive implantable cardioverter-defibrillator treatment. 123I-beta-methyl-iodophenylpentadecanoic acid (BMIPP) plays an important role for identifying ischemia at rest, based on the unique capability to represent persistent metabolic alteration after recovery of ischemia, so called ischemic memory. Since BMIPP abnormalities may represent severe ischemia or jeopardized myocardium, it may permit risk analysis in CAD patients, particularly for those with chronic kidney disease and/or hemodialysis patients. This review will discuss about recent development of these important iodinated compounds

Long-term outcome of chronic dialysis in children

As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life. However, some will require long-term dialysis or may return intermittently to dialysis during the course of their chronic kidney disease (CKD). This article reviews the available outcome data for children on chronic dialysis as well as extrapolating data from the larger adult dialysis experience to inform our paediatric practice. The multiple factors that may influence outcome, and, particularly, those that can potentially be modified, are discussed

Voices off: Stanley Milgram's cyranoids in historical context

This article revisits a forgotten, late project by the social psychologist Stanley Milgram: the ‘cyranoid’ studies he conducted from 1977 to 1984. These investigations, inspired by the play Cyrano de Bergerac, explored how individuals often fail to notice when others do not speak their own thoughts but instead relay messages from a hidden source. We situate these experiments amidst the intellectual, cultural, and political concerns of late Cold-War America and show how Milgram’s studies pulled together a variety of ideas, anxieties, and interests that were prevalent at that time and have returned in new guises since. In discussing the cyranoid project’s background and afterlife, we argue that its strikingly equivocal quality has lent itself to multiple reinterpretations by historians, psychologists, performers, artists and others. Our purpose is neither to champion Milgram’s work nor amplify the critiques already made of his methods. Rather it is consider the uncertain, allusive, and elusive aspects of the cyranoid project, and to seek to place that project ‘in context’, whilst asking where ‘context’ might end. We show how the experiments’ range of meanings, in different temporal registers, far exceeded the explanatory rubric that Milgram and his intellectual critics provided at that time; and ponder the risk for the historian of making anachronistic or teleological assumptions. In short, cyranoids, we argue, invite our open-ended exploration of ‘voices off stage’ in social and psychological relations, and offer a useful tool for thinking about historical context and the nature of historical interpretations

On some spurious modes issues in shallow water models using a linear algebra approach

Numerical methods that are usually employed in ocean modelling are typically finite-difference, finite and spectral-element techniques. For most of these methods the coupling between the momentum and continuity equations is a delicate problem and it usually leads to spurious solutions in the representation of inertia-gravity waves. The spurious modes have a wide range of characteristics and may take the form of pressure (surface-elevation), velocity and/or Coriolis modes. The modes usually cause aliasing and an accumulation of energy in the smallest-resolvable scale, leading to noisy solutions. The Fourier analysis has proven practical and beneficial to describe the spurious solutions of several classical schemes. However it is restricted to uniform meshes on which the variables are regularly distributed. In this paper, a linear algebra approach is proposed to study the existence and the behaviour of stationary spurious modes associated with zero frequency, for some popular finite-difference and finite-element grids. The present approach is performed on uniform meshes but it applies equally well to regular as well as unstructured meshes with irregular geometry for the finite-element schemes

On some spurious mode issues in shallow-water models using a linear algebra approach

Numerical methods that are usually employed in ocean modelling are typically finite-difference, finite and spectral-element techniques. For most of these methods the coupling between the momentum and continuity equations is a delicate problem and it usually leads to spurious solutions in the representation of inertia-gravity waves. The spurious modes have a wide range of characteristics and may take the form of pressure (surface-elevation), velocity and/or Coriolis modes. The modes usually cause aliasing and an accumulation of energy in the smallest-resolvable scale, leading to noisy solutions. The Fourier analysis has proven practical and beneficial to describe the spurious solutions of several classical schemes. However it is restricted to uniform meshes on which the variables are regularly distributed. In this paper, a linear algebra approach is proposed to study the existence and the behaviour of stationary spurious modes associated with zero frequency, for some popular finite-difference and finite-element grids. The present approach is performed on uniform meshes but it applies equally well to regular as well as unstructured meshes with irregular geometry for the finite-element schemes. © 2004 Elsevier Ltd. All rights reserved