A simple and effective approach for detecting maternal cell contamination in molecular prenatal diagnosis

The presence of maternal cells in fetal samples constitutes a serious potential source for prenatal misdiagnosis. Here we present our approach for detecting maternal cell contamination (MCC) at prenatal diagnosis for eight monogenic disorders (autosomal recessive: β-thalassaemia, sickle-cell anaemia, cystic fibrosis, prelingual deafness; autosomal dominant: achondroplasia, Huntington disease, myotonic dystrophy, neurofibromatosis type I; X-linked: spinobulbar muscular atrophy). Our aim was to apply a simple and low-cost approach, which would easily and accurately provide information on the fetal tissue MCC status. MCC testing was applied to cases of recessive inheritance where the primary mutation screening of the fetus revealed the presence of the maternal mutation, to cases concerning dominant inheritance and to cases of multiple gestation. The potential presence of maternal cells was determined by the amplification of the 3′-HVR/APO B, D1S80, THO1 and VNTRI of vWf polymorphic loci, which have previously demonstrated high heterozygosity in Caucasians. Among 135 prenatal diagnoses, 44 finally needed to be tested for MCC (32.6%). MCC was detected in four cases, where DNA was isolated directly from chorionic villi samples (CVS), and in one case with DNA isolated directly from amniotic fluid (AF). In almost 90% of cases a simple test of one polymorphic locus provided sufficient information about MCC. The choice of the appropriate locus is therefore essential, while the simultaneous screening of both parents provides the means for distinguishing non-informative sites about MCC. Copyright © 2002 John Wiley & Sons, Ltd.     

Dandy – Walker syndrome and corpus callosum agenesis in 5p deletion

5p deletion syndrome commonly known as cri du chat is well described in affected neonates with catlike cry and hypotonia. Karyotyping will usually show a deletion of the short arm of one chromosome 5 with variable breakpoints. Only a few cases have been reported prenatally, and the fetal form of the syndrome has not been clearly individualised. We report a new case of 5p deletion syndrome diagnosed prenatally in association with Dandy–Walker syndrome and agenesis of the corpus callosum. Other brain anomalies have been reported previously, but this unusual association suggests the use of a specific probe in the investigation of these malformations. Copyright © 2005 John Wiley & Sons, Ltd.     

A study of the growth and decay of cigarette smoke NOx in ambient air under controlled conditions

The amount of NO₂ and NO produced by the machine smoking of cigarettes was determined for 15 commercial Canadian brands. Average yield of NO was 1.44 μmoles or about 13% of the average reported for American cigarettes. Levels of NO₂ were less than 12% of NO and were probably due to the oxidation of NO. In order to assess the contribution of tobacco smoke to levels of NO in ambient air, 5 brands of cigarettes were smoked in 27 cubic meter controlled environment room. Ventilation conditions were either 2.5 or 5.0 air changes per hour (ACH) and each experiment was replicated 3 times for a total of 30 experiments. Ventilation rates of 0.3 and 1.5 ACH were also selected in a second series of experiments in which only one brand of cigarette was smoked. Least squares estimates for the effective ventilation rates were obtained in the usual manner after linearizing the decay portion of the NO time curve. In each of the experiments, the regression explained at least 95% of the variation in the levels of NO with time. Loss of NO due to factors other than ventilation appeared to be constant within experimental error and averaged 2.22 ACH. Equilibrium values for NO were grossly underestimated when results from currently accepted proecedures for smoke analysis were used in modeling the growth and decay of NO. Goodness-of-fit was improved when equilibrium values were estimated based on observed levels in ambient air. This approach may be more suitable for evaluating the potential contribution of cigarette smoke to levels of indoor air pollutants.     

Risky health and safety habits related to perceived value of the future

Risk homeostasis theory postulates that people accept a specific level (target level) of risk in a given activity in return for benefits accruing from that activity. It follows that, if people expect a great deal from the future, the less likely they are to jeopardise it by taking risks in respect of their health and safety. One effective method for reducing target level of risk are incentives, and the available literature contains ample evidence of the effectiveness of incentives programmes in accident prevention. As incentives essentially imply an enhanced quality of life in the future, the question arises as to how expectations of the future may be related to health and safety habits. In order to explore the relationship between perceived value of the future and health and safety habits, an analysis of the psychological literature on individual differences in future time orientation/perspective is presented. Four factors are identified: (1) clear ideation of the future, (2) active planning for the future, (3) time pressure, and (4) optimistic expectations about events outside one's own control. It is hypothesised that factors (1) and (2) are associated with positive health and safety habits, while factors (3) and (4) may characterise individuals with relatively high target levels of physical risk. Research questions and procedures for the study of these relationships are discussed.     

Design and validation of a practical index for trauma assessment

In the past 20 years a variety of indices have been suggested for measuring the severity of trauma, however none of them meets the requirement of being a simple and objective instrument that can be utilized efficiently by lay persons and providers of health services without previous experience in triaging. A new system has been proposed which meets this requirement and which has been validated with 197 injured persons at the emergency ward of the Valle University Hospital in Call, Colombia. The instrument showed a high level of concordance with the conventional triaging method and classifies victims into four categories: critical with recovery unlikely, critical but recoverable, moderately serious, and ambulatory. There is discussion on the reliability of this instrument and it is recommended that it be validated with victims from larger disasters. Regardless, it has the advantage of being specific and free of the subjectivity that characterizes other indices.     

The role of socio-economic data in food needs assessment and monitoring

This paper reviews six case studies examined as part of a project to review targetting methodologies employed by non-government organisations in Africa during the 1984-6 food crisis. Most agencies have not yet fully evaluated the role of data in informing policy decisions during their respective emergency programmes. The case studies presented reflect a wide variety of approaches to targetting emergency food aid that are based largely on the use of 'socio-economic' data. The recent emergency relief operations in Africa seem to indicate a change in relief agencies' approaches to the assessment and monitoring of needs of the affected populations. Earlier dependance on nutritional data has given way to an increasing reliance on the use of socio-economic indicators. There was a wide variation in the case studies of the type of indicators collected and utilised in needs assessment and monitoring. There were those who relied almost exclusively on nutritional data to target resources during the 1984-86 African crisis, and others whose experiences during that period lead them to attach more weight to socio-economic data. Other agencies appear to have recognised the problems of relying solely on nutritional data to target food aid during their 1984–86 emergency programmes, and thus more or less abandoned classical anthropometric surveys in their needs assessment and monitoring methodologies during this period. Thus nutritional data has a less significant role in the decision making process than previously had been the case.