RESUMEN
We assessed how information on complications at caesarean section was shared with mothers undergoing this operation and determined whether this information was within the NICE and RCOG guidelines. A postal questionnaire survey, involving 170 consultant-led maternity units in England, was sent out. We analysed the methods of giving this information and compliance with National guidelines and explored the need to standardise this information nationally. A response rate of 84.11% was achieved (143/170). A total of 50/143 (34.97%) units share information using risk stickers, pre-typed or standard checklist forms, which aim to achieve consistency of information sharing. In contrast 92/143 (64.34%) units rely on information given from memory of doctors. Subgroup analysis of 23 hospitals revealed large heterogeneity in information provided to women before caesarean section. Our survey indicated a large variation in the information given to women prior to caesarean section and thus the need for standardised written information.
Asunto(s)
Cesárea/legislación & jurisprudencia , Consentimiento Informado/estadística & datos numéricos , Cesárea/ética , Femenino , Adhesión a Directriz , Comunicación en Salud/métodos , Humanos , Auditoría Médica , Guías de Práctica Clínica como Asunto , EmbarazoRESUMEN
Consultant obstetricians and gynaecologists are often recalled from home back into hospital to attend emergencies. We audited their driving practices and compliance to motor traffic regulations on recall to these emergencies with the aid of a questionnaire survey. A total of 218 of the 300 UK consultants surveyed responded. Some 65% of those who owned a green warning light beacon (GWL) admitted to speeding on some journeys and 46% ignored red lights; 84% of non-owners of a GWL would speed and 28% would ignore a red light. A total of 37 consultants had been stopped for traffic violations, nine with a GWL and 28 without. Five consultants had been involved in accidents returning to hospital to attend an emergency. Obstetricians and gynaecologists are disregarding motor traffic regulations in order to attend emergencies.
Asunto(s)
Conducción de Automóvil/estadística & datos numéricos , Servicios Médicos de Urgencia/estadística & datos numéricos , Ginecología/estadística & datos numéricos , Obstetricia/estadística & datos numéricos , Femenino , Humanos , MasculinoAsunto(s)
Quistes Aracnoideos/terapia , Cesárea , Complicaciones del Embarazo/terapia , Adulto , Femenino , Humanos , EmbarazoRESUMEN
OBJECTIVES: To determine consultants' compliance with motor traffic regulations on recall to hospital to attend emergencies, and ownership and use of green warning lights (GWLs). To determine the views of senior police officers on consultants complying with traffic regulations on emergency recall with and without GWLs. METHOD: Questionnaire survey of all consultants in obstetrics and gynaecology, paediatrics and emergency medicine in the Yorkshire Deanery, UK, and members of the Association of Chief Police Officers (ACPO). RESULTS: 220 consultant questionnaires were distributed and 166 replies were received; 21% of respondents owned a GWL. Almost 50% of consultants would consider exceeding speed limits when returning to an emergency. Between 43% and 80% consultants would cross red traffic lights; driving habits varied with usage and ownership of a GWL. 12.7% (21) of respondents had been stopped for traffic violations attending emergencies, 2.4% (4) had been prosecuted and 4.8% (8) had been involved in accidents. The ACPO advised that consultants should observe all traffic regulations at all times. CONCLUSION: Consultants recalled to their hospitals for emergencies disregard speed restrictions and traffic light signals both with and without GWLs and risk both accident and prosecution for ignoring traffic legislation. They should consider using a GWL to ease their progress through traffic when attending an emergency and observe all traffic laws.
Asunto(s)
Accidentes de Tránsito/prevención & control , Conducción de Automóvil/legislación & jurisprudencia , Medicina de Emergencia , Médicos , Seguridad , Accidentes de Tránsito/estadística & datos numéricos , Humanos , Policia , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Reino UnidoRESUMEN
The restoration of male fertility in the sorghum IS1112 C (A3) male-sterile cytoplasm is through a two-gene gametophytic system involving complementary action of the restoring alleles Rf3 and Rf4. To develop markers suitable for mapping rf4, AFLP technology was applied to bulks of sterile and fertile individuals from a segregating BC(3)F(1) population. Three AFLP markers linked to rf4were identified and subsequently converted to STS/CAPS markers, two of which are co-dominant. Based on a population of 378 BC(1)F(1) individuals, two STS/CAPS markers, LW7 and LW8, mapped to within 5.31 and 3.18 cM, respectively, of rf4, while an STS marker, LW9, was positioned 0.79 cM on the flanking side of rf4. Markers LW8 and LW9 were used to screen sorghum BAC libraries to identify the genomic region encoding rf4. A series of BAC clones shown to represent a genomic region of linkage group E were identified by the rf4-linked markers. A contig of BAC clones flanking the LW9 marker represent seed clones on linkage group E, from which fine mapping of the rf4 locus and chromosome walking can be initiated.
RESUMEN
A marked reduction of mitochondrial atp6 transcript-editing capability in sorghum anthers and pollen has been invoked as a factor in the loss of viability of male gametophytes in lines carrying the IS1112C male-sterile cytoplasm. We initiated a systematic examination of transcript editing of sorghum atp6 during microgametogenesis, from microspores through pollen, in two sets of male-fertile and near-isogenic, male-sterile lines. Transcript editing in cDNA populations from fertile lines indicated an average of about 90% editing among 15 sites examined. Parallel samples from sterile lines demonstrated a detectable reduction in editing efficiency, most evident in late pollen samples. However, editing efficiency in these cells averaged 80%, substantially higher than the 20% previously observed. Thus male-sterile lines retain substantial atp6-editing efficiency in an environment where the sterility and fertility restoration traits are stably expressed. Drastically reduced editing of atp6 transcripts in anthers and pollen of male-sterile sorghum is not demonstrable in a field environment; and thus it is not a factor in the loss of microgametophyte viability in this system.
Asunto(s)
Grano Comestible/genética , Proteínas de Plantas/genética , Edición de ARN , Secuencia de Bases , Grano Comestible/fisiología , Mitocondrias/genética , ATPasas de Translocación de ProtónRESUMEN
OBJECTIVE: To evaluate current knowledge and practice among pregnant women about the use of car restraint systems during pregnancy. DESIGN: A structured questionnaire. SETTING: District hospital antenatal clinic. PARTICIPANTS: Two hundred pregnant women attending for their routine mid-pregnancy anomaly scan. MAIN OUTCOME MEASURES: The women were asked about seatbelt and airbag usage, source of information about restraint systems and the legal requirements and recommendations regarding car safety systems. RESULTS: One hundred fifty-nine women (80%) completed the questionnaire. Ninety-eight percent wore seatbelts in the front, 68% wore seatbelts in the back of a car, 48% correctly identified where to place the seatbelt and 37% had received information on seatbelt use while pregnant. The latter were more likely to correctly position their restraints than those who had received no information (P = 0.03). Thirty-nine percent had an airbag system fitted and one woman had de-activated it. Fifty-eight percent were aware seatbelt use was a legal requirement for driver and passengers when fitted. CONCLUSIONS: Many pregnant women are ignorant of the correct usage of seatbelts, their positioning and legal requirements. This puts their own wellbeing, and that of the fetus, at risk. Women should receive written instructions and advice from well informed health professionals and be encouraged always to wear a correctly positioned seatbelt. Education increases compliance and correct usage.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Cinturones de Seguridad/estadística & datos numéricos , Adulto , Airbags , Femenino , Humanos , Embarazo , Segundo Trimestre del Embarazo , Cinturones de Seguridad/legislación & jurisprudencia , Reino UnidoRESUMEN
The Health Education Authority's campaign, encouraging the use of periconceptional folic acid in the prevention of neural tube defects, started in February 1996 and is ongoing. Its effectiveness was assessed using a questionnaire, answered by patients not exposed to the campaign and by those that were. The study population was comprised of 337 women in approximately their 20th week of pregnancy, attending antenatal clinic for a routine fetal anatomy ultrasound scan. Data were collected on aspects of folate awareness, intake and sources of advice, before and after the campaign's start. Significant increases in preconceptional and total folate consumption, awareness of folate's benefits, and GP prescription were seen as the study went on. Unplanned pregnancy prevented compliance with periconceptional folate guidelines. We conclude that whilst the promotional campaign seemed to work in York, fortification of foodstuffs may need to be used to increase folate consumption in those with unplanned pregnancy.
RESUMEN
The management of 18 women complaining of superficial dyspareunia is reviewed. Primary treatment consisted of self-vaginal dilatation using graduated glass dilators on an outpatient basis. All patients were given verbal explanation and written instructions. Treatment was considered successful with dilator therapy in 14 (77.8%) women. Three (16.7%) women required additional therapy in the form of surgery or psychotherapy. We conclude that in selected cases, self-vaginal dilator usage on an outpatient basis is effective primary therapy for superficial dyspareunia.
RESUMEN
RNA editing and cytoplasmic male sterility are two important phenomena associated with higher plant mitochondria. We recently have shown a potential function of RNA editing in CMS development. The frequency of atp6 RNA editing was specifically reduced in anthers of male-sterile Sorghum bicolor, which increased in frequency in partially restored progeny. Here we present data that show that the loss of RNA editing capability also occurs in a second nuclear background that allows the expression of male sterility. Loss of RNA editing thus appears to be associated with unique combinations of male-sterile cytoplasm and non-restoring nuclear backgrounds. In addition, the reduction of RNA editing affects both gametophytic and sporophytic anther cell-types but not other floral tissues. An analysis of F(2) plants exhibiting different levels of fertility indicates a co-segregation of fertility restoration and atp6 RNA editing. The atp6 transcript abundance is similar in seedlings and anthers of male-sterile, partially restored, and male-fertile lines and thus is not associated with loss of atp6 RNA editing in anthers. A model for RNA editing and male sterility based on the data available is presented. Functional correlations with other CMS systems are also discussed.
Asunto(s)
Núcleo Celular/genética , Citoplasma/genética , Genes de Plantas/genética , Magnoliopsida/genética , Proteínas de Plantas/genética , Edición de ARN , Cruzamientos Genéticos , Diploidia , Fertilidad , Regulación de la Expresión Génica de las Plantas , Haploidia , Magnoliopsida/citología , Magnoliopsida/fisiología , Modelos Genéticos , Especificidad de Órganos , Estructuras de las Plantas/citología , Estructuras de las Plantas/genética , Estructuras de las Plantas/fisiología , Polen/citología , Polen/genética , Polen/fisiología , ATPasas de Translocación de Protón , ARN/genética , ARN/metabolismo , ARN Mitocondrial , ARN de Planta/genética , ARN de Planta/metabolismo , Análisis de Secuencia de ADN , Transcripción Genética/genéticaRESUMEN
The sorghum line IS1112C carries a male sterility-inducing cytoplasm when introduced into nuclear backgrounds that do not include fertility restoration genes. An mtDNA chimeric configuration resulting from recombination/duplication with atp9 resulted in the formation of orf107, a chimeric open reading frame. Transcription of orf107 is driven by three promoters, and abundant whole-length transcripts are detected in male-sterile lines. Fertility restoration is exacted through a unique two-gene gametophytic system requiring complementary action of genes designated Rf3 and Rf4. In male-sterile lines carrying Rf3, or lines restored to fertility, an enhanced nucleolytic transcript processing activity is targeted within orf107, cleaving 75% of whole-length transcripts. Rf3 thus confers or regulates the nucleolytic processing activity. A correlation between the frequency of RNA editing at two sites in orf107 and transcript processing suggests that processing may be dependent on templates edited at these sites. In addition, editing of atp6 transcripts is specifically reduced in anthers/pollen of male-sterile lines. Partially restored F1s and segregating F2s exhibit atp6 editing frequencies consistent with the possibility that Rf4 may confer the restitution of normal editing frequency. Thus RNA editing may be involved in features of fertility restoration in this unusual system.
Asunto(s)
Grano Comestible/genética , Edición de ARN , Secuencia de Aminoácidos , Secuencia de Bases , Núcleo Celular/metabolismo , ADN Complementario , Grano Comestible/fisiología , Datos de Secuencia Molecular , Conformación de Ácido Nucleico , Sistemas de Lectura Abierta , Procesamiento Postranscripcional del ARN , ARN Mensajero/química , ARN Mensajero/genéticaRESUMEN
Defective nuclear-cytoplasmic interactions leading to aberrant microgametogenesis in sorghum carrying the IS1112C male-sterile cytoplasm occur very late in pollen maturation. Amelioration of this condition, the restoration of pollen viability, involves a novel two-gene gametophytic system, wherein genes designated Rf3 and Rf4 are required for viability of individual gametes. Rf3 is tightly linked to, or represents, a single gene that regulates a transcript processing activity that cleaves transcripts of orf107, a chimeric mitochondrial open reading frame specific to IS1112C. The mitochondrial gene urf209 is also subject to nucleus-specific enhanced transcript processing, 5' to the gene, conferred by a single dominant gene designated Mmt1. Examinations of transcript patterns in F2 and two backcross populations indicated cosegregation of the augmented orf107 and urf209 processing activities in IS1112C. Several sorghum lines that do not restore fertility or confer orf107 transcript processing do exhibit urf209 transcript processing, indicating that the activities are distinguishable. We conclude that the nuclear gene(s) conferring enhanced orf107 and urf209 processing activities are tightly linked in IS1112C. Alternatively, the similarity in apparent regulatory action of the genes may indicate allelic differences wherein the IS1112C Rf3 allele may differ from alleles of maintainer lines by the capability to regulate both orf107 and urf209 processing activities.
Asunto(s)
Grano Comestible/genética , Fertilidad/genética , Procesamiento Postranscripcional del ARN , ARN Mensajero/metabolismo , Alelos , Genes Dominantes , Ligamiento Genético , Sistemas de Lectura Abierta , Factores de Terminación de Péptidos/genética , ARN Mensajero/genéticaRESUMEN
OBJECTIVE: To determine if diclofenac suppositories administered prophylactically produce effective and lasting analgesia following perineal injury. DESIGN: A randomised double blind placebo controlled trial. SETTING: York District Hospital. POPULATION: One hundred women sustaining objective perineal injury (second degree tear or episiotomy) during spontaneous vaginal delivery at term. METHODS: Suppositories were administered at the time of repair and approximately 12 hours later. The suppositories were randomised prior to issue by the pharmacy department and contained either 100 mg diclofenac or placebo. MAIN OUTCOME MEASURES: Pain scores assessed at 12, 24, 48 and 72 hours after delivery using a six point numerical scoring system and the use of additional analgesia and local treatments to the perineum. RESULTS: The mean pain score was significantly reduced in the diclofenac group at 24, 48 and 72 hours after delivery (0.86, 0.7 and 0.59, respectively) compared with the control group (1.64, 1.31 and 1.5; P < 0.005). In addition there was less supplementary analgesia required (eight women only at 72 hours compared with 15 in the control group) and this was limited to paracetamol or topical treatments to the perineum. CONCLUSION: Prophylactic rectal diclofenac provides effective analgesia after perineal repair and its effect appears to be maintained into the second and third postpartum days.
Asunto(s)
Analgesia Obstétrica/métodos , Antiinflamatorios no Esteroideos/administración & dosificación , Diclofenaco/administración & dosificación , Complicaciones del Trabajo de Parto , Dolor Postoperatorio/prevención & control , Perineo/lesiones , Administración Rectal , Adulto , Método Doble Ciego , Femenino , Humanos , Dimensión del Dolor , Embarazo , Resultado del TratamientoRESUMEN
Nucleolytic processing of transcripts within mitochondrial orf107, associated with male sterility in sorghum, is regulated by the fertility restoration gene Rf3, conferring 75% cleavage of whole-length transcripts. Two transcript editing sites are 81% and 61% edited in rf3rf3 lines, while these sites are 41% and 10% edited in the remaining whole-length transcripts in an Rf3Rf3 line. RNA editing and processing efficiency in F1 progeny were similar to the Rf3Rf3 parent, and analyses of backcross progeny indicated that all rf3rf3 lines were characterized by high editing efficiency. We postulate that highly edited transcripts within the population are quickly processed in lines carrying Rf3, generating a residual population of poorly edited transcripts. Thus, action of Rf3 may have no direct affect on RNA editing, and may be dependent on a substrate of highly edited transcripts. These data indicate a potentially novel role of RNA editing in gene expression through an influence on the efficiency of transcript processing.
Asunto(s)
Grano Comestible/genética , Mitocondrias/genética , Proteínas Nucleares/genética , Edición de ARN/genética , Secuencia de Aminoácidos , Secuencia de Bases , Sitios de Unión/genética , Núcleo Celular/química , Núcleo Celular/genética , ADN Mitocondrial/genética , Grano Comestible/química , Grano Comestible/fisiología , Fertilidad/genética , Fertilidad/fisiología , Genes de Plantas/genética , Heterocigoto , Mitocondrias/química , Datos de Secuencia Molecular , Estructura Molecular , Proteínas Nucleares/fisiología , Conformación de Ácido Nucleico , Sistemas de Lectura Abierta/genética , Proteínas de Plantas/genética , Proteínas de Plantas/fisiología , ARN/genética , ARN/metabolismo , Edición de ARN/fisiología , ARN Mitocondrial , Transcripción Genética/genéticaRESUMEN
Defects in the human mitochondrial genetic system result in some diseases. These disorders are the result of rearrangements or point mutations in mitochondrial genes. In higher plants mutations and rearrangements in the mitochondrial DNA are believed to cause cytoplasmic male sterility (CMS), a mitochondrially inherited inability to produce viable pollen. In sorghum, formation of CMS is strongly correlated with anther-specific loss of mitochondrial atp6 RNA editing. Here we show that this loss of atp6 RNA editing mimics point mutations at codons that cause severe disorders in humans. We conclude that (i) loss of RNA editing in sorghum anthers probably causes CMS, (ii) similarities exist in the onset of mitochondrial dysfunction in plant and human tissues, and (iii) the evolutionary appearance of RNA editing provided a mechanism to compensate for otherwise lethal point mutations.
Asunto(s)
Codón , Miopatías Mitocondriales/genética , Mutación , Proteínas de Plantas/genética , Plantas/genética , Secuencia de Aminoácidos , ADN Mitocondrial/genética , Fertilidad , Humanos , Datos de Secuencia Molecular , Proteínas de Plantas/química , ATPasas de Translocación de Protón , Homología de Secuencia de AminoácidoRESUMEN
Transcriptional initiation and processing was examined for three sorghum mitochondrial DNA genes (atp6-1, atp6-2, urf209) and two open reading frames (orf265/130, orf107) to characterize sequences associated with initiation and other transcriptional strategies for this species. The 5' termini of ten transcripts were determined by primer extension, and mtRNA was capped with guanylyl transferase and annealed to anti-sense riboprobes to identify transcriptional initiation regions. Eight transcript termini were suitable substrates for guanylyl transferase, indicating the presence of one (atp6-1, atp6-2, urf209), two (orf265/130), or three (orf107) promoters for the five examples. The majority of the putative promoters were associated with single primer-extension termini, while two examples exhibited two transcript-initiation sites within the promoter. Four examples were characterized by initiated transcripts without subsequent processing, indicating that processing is not obligatory. Each of the putative promoter regions included significant A/T-rich 5' regions, consistent with previous examples, but four exceptions to a consensus core YRTA sequence were identified. The anomalies (AATA, CTTA) suggest plasticity in the primary structure of the core region of higher-plant mitochondrial DNA promoters.
Asunto(s)
ADN Mitocondrial/química , ADN Mitocondrial/genética , Grano Comestible/genética , Transcripción Genética , Secuencia de Bases , Secuencia Conservada , Grano Comestible/metabolismo , Datos de Secuencia Molecular , Nucleotidiltransferasas/metabolismo , Sistemas de Lectura Abierta , Regiones Promotoras Genéticas , Alineación de Secuencia , Homología de Secuencia de Ácido Nucleico , Especificidad por SustratoRESUMEN
Sorghum mitochondrial atp9 is polymorphic among male-sterile cytoplasms, but each cytoplasm is characterized by a major 650 nt transcript, regardless of fertility status. The gene is positioned 323 bp 3' to trnfM. Primer extension revealed multiple atp9 5' transcript termini, distributed from +1 to +28 3' to trnfM; the termini could be labeled with polynucleotide kinase, suggesting that they result from the maturation of trnfM. Guanylyltransferase experiments, however, showed that four of the termini were capable. The juxtaposition of a putative promoter 3' to trnfM results in a unique atp9 transcript population consisting of primary and processed transcripts.
Asunto(s)
Grano Comestible/enzimología , Grano Comestible/genética , ATPasas de Translocación de Protón Mitocondriales , Proteínas de Plantas , Proteolípidos/genética , ATPasas de Translocación de Protón/genética , ARN de Transferencia de Metionina/genética , ARN/genética , Transcripción Genética , Secuencia de Aminoácidos , Proteínas de Arabidopsis , Secuencia de Bases , Datos de Secuencia Molecular , Polimorfismo Genético , Proteolípidos/química , ATPasas de Translocación de Protón/química , ARN/química , Caperuzas de ARN/química , Caperuzas de ARN/genética , Procesamiento Postranscripcional del ARN , ARN Mitocondrial , Análisis de SecuenciaRESUMEN
A chimeric mitochondrial DNA (mtDNA) configuration of the cytoplasmic male-sterile (cms) sorghum line IS1112C includes a 321 bp open reading frame designated orf107, encoding a predicted polypeptide product of 11.85 kDa. The open reading frame, similar to several other genes associated with cms, consists of amino-terminal sequences derived from an obligate gene. Unlike other examples to date, however, the carboxy-terminal sequences are highly similar to the carboxy terminus of an open reading frame implicated in cms of rice, orf79. The amino-terminal 31 residues of orf107 are 84% similar to atp9, and the carboxy-terminal 49 residues are 57% identical and 80% similar to the carboxy terminus of orf79. Transcripts of orf107 are edited, with four C-to-U changes that alter amino acids. Sorghum lines partially or fully restored to fertility exhibit a high-efficiency internal-orf107 transcript processing activity, precluding abundant whole-length transcripts, while male-sterile lines exhibit only a trace of the activity. Previous data on the abundance of a 12kDa in organello-synthesized polypeptide in male-sterile versus male-fertile lines are correlated with differential orf107 transcript processing activity of these lines. Examinations of backcross and F2 lines suggest a gametophytic mode of restoration, and indicate that enhanced transcript processing activity is necessary, but not sufficient, to restore full fertility. These novel observations indicate that mitochondrial open reading frames associated with cms in different species can include highly similar motifs, and that fertility restoration could involve a mechanism by which synthesis of a cms-associated gene product may be precluded through internal transcript cleavage.
Asunto(s)
ADN Mitocondrial/genética , ADN de Plantas/genética , Grano Comestible/genética , Secuencia de Aminoácidos , Secuencia de Bases , Mapeo Cromosómico , Clonación Molecular , Cartilla de ADN/genética , Grano Comestible/fisiología , Fertilidad/genética , Genes de Plantas , Datos de Secuencia Molecular , Sistemas de Lectura Abierta , Homología de Secuencia de Aminoácido , Homología de Secuencia de Ácido Nucleico , Transcripción GenéticaRESUMEN
We describe fundamental characteristics of sorghum mitochondrial orf25, urf209, and a related chimeric configuration, orf265/130, which is restricted to the IS1112C source of cytoplasmic male sterility in sorghum. Transcripts of urf209 are edited at ten nucleotides, resulting in nine amino-acid changes predicted from genomic sequences. The cDNA-predicted polypeptide product is 23.6 kDa, while Western blot analyses identify a product of 20k Da. Transcription of urf209 is characterized by one or two transcripts, dependent on nuclear background, but this difference is not related to male fertility status. The orf265/130 chimeric region includes 288 bp 95% identical to sequences 5' to maize T-cytoplasm T-urf13 and atp6, which includes a common transcription initiation site, and terminates with a recombinational event involving urf209. The urf209 similarity extends 189 bp, followed by sequences duplicated 5' to sorghum atp6-2. Sequences immediately 3' to the atp6-2 similarity include a second in-frame start codon, defining orf130. Structural features 5' to orf130 are shared with motifs found 5' to several translated mitochondrial open reading frames. The orf265/orf130 configuration is uniquely transcribed, and transcripts of orf130 exhibit one silent RNA editing event. Transcription in somatic cells is not altered by male fertility status.