Chemical composition, nutritive value and health benefits of edible clam Meretrix casta (Chemnitz) from West Coast of India

The present study was undertaken with a view to determine the nutraceutical value of the commonly consumed edible clam, Meretrix casta (Chemnitz), based on the identification of its organic chemical constituents particularly lipids and carbohydrates. Electrospray ionization tandem mass analysis of the bivalve indicated maltodextrins to be the major carbohydrate constituent. Triacylglycerols (TAGs) (0.88%, dry weight) were rich in C14:0, C16:0 to C18:0 (6-11%) saturated and monounsaturated palmitoleic (C16:1n9c; 11.76%) and oleic fatty acids (C18:1n9c; 14.53%). Though the clams contained PUFAs which are known to be beneficial in lowering the risk of cardiovascular diseases, they were devoid of docosahexaenoic acid (C22:6n3). Maltodextrins being less digestible than glucose beneficially affects the host by selectively stimulating the growth of gut microflora particularly Lactobacillus and Bifidobacteria. These microflora inhibit colonization of pathogens by producing butyrate. The profile of sterols (1.67%, dry wt.) showed it to be a complex mixture of C26, C27, C29 and C30. To our knowledge no reports are available in the literature on the identification of maltodextrins and of positional distribution of PUFA's at the sn2 position of TAGs in M. casta. The results of this study demonstrated the positive attributes of the bivalve for human consumption.

Synergistic metabolic benefits of an exenatide analogue and cholecystokinin in diet-induced obese and leptin-deficient rodents

AIM

To test the impact of cholecystokinin (CCK) plus either amylin or a glucagon-like peptide-1 receptor (GLP-1R) agonist on metabolic variables in diet-induced obese (DIO) rodents.

METHODS

A stabilized acetylated version of CCK-8 (Ac-Y*-CCK-8), selective CCK1 receptor (CCK1R) or CCK2 receptor (CCK2R) agonists, amylin or the GLP-1R agonist and exenatide analogue AC3174 were administered in select combinations via continuous subcutaneous infusion to DIO rats for 14 days, or Lep(ob) /Lep(ob) mice for 28 days, and metabolic variables were assessed.

RESULTS

Combined administration of Ac-Y*-CCK-8 with either amylin or AC3174 induced greater than additive weight loss in DIO rats, with the overall magnitude of effect being greater with AC3174 + Ac-Y*-CCK-8 treatment. Co-infusion of AC3174 with a specific CCK1R agonist, but not a CCK2R agonist, recapitulated the weight loss mediated by AC3174 + Ac-Y*-CCK-8 in DIO rats, suggesting that synergy is mediated by CCK1R activation. In a 4 × 4 full-factorial response surface methodology study in DIO rats, a synergistic interaction between AC3174 and the CCK1R-selective agonist on body weight and food intake was noted. Co-administration of AC3174 and the CCK1R-selective agonist to obese diabetic Lep(ob) /Lep(ob) mice elicited a significantly greater reduction in percentage of glycated haemoglobin and food intake relative to the sum effects of monotherapy groups.

CONCLUSIONS

The anti-obesity and antidiabetic potential of combined GLP-1R and CCK1R agonism is an approach that warrants further investigation.

Discovery of a new subclass of α-conotoxins in the venom of Conus australis

Cone snails (Conus sp.) are poisonous animals that can be found in all oceans where they developed a venomous strategy to prey or to defend. The venom of these species contains an undeniable source of unique and potent pharmacologically active compounds. Their peptide compounds, called conotoxins, are not only interesting for the development of new pharmaceutical ligands, but they are also useful for studying their broad spectrum of targets. One conotoxin family in particular, the α-conotoxins, acts on nicotinic acetylcholine receptors (nAChRs) which dysfunctions play important roles in pathologies such as epilepsy, myasthenic syndromes, schizophrenia, Parkinson's disease and Alzheimer's disease. Here we define a new subclass of the α-conotoxin family. We purified the venom of a yet unexplored cone snail species, i.e. Conus australis, and we isolated a 16-amino acid peptide named α-conotoxin AusIA. The peptide has the typical α-conotoxin CC-Xm-C-Xn-C framework, but both loops (m/n) contain 5 amino acids, which has never been described before. Using conventional electrophysiology we investigated the response of synthetically made globular (I-III, II-IV) and ribbon (I-IV, II-III) AusIA to different nicotinic acetylcholine receptors. The α7 nAChR was the only receptor found to be blocked with a similar potency by both peptide-configurations. This suggests that both α5/5 conotoxin isomers might be present in the venom gland of C. australis. NMR spectroscopy showed that no secondary structures define the peptides' three-dimensional topology. Moreover, the ribbon configuration, which is generally considered to be non-native, is more stable than the globular isomer. Accordingly, our findings show relevancy concerning the α-conotoxin classification which might be helpful in the design of novel therapeutic compounds.

Design and synthesis of marine natural product-based 1H-indole-2,3-dione scaffold as a new antifouling/antibacterial agent against fouling bacteria

Marine organisms such as seaweeds, sponges and corals protect their own surfaces from fouling by their high anesthetic, repellant, and settlement inhibition properties. Within the marine ecosystem, evolution has allowed for the development of certain antifouling properties. Isatin is a biologically active chemical produced by an Alteromonas sp. strain inhibiting the surface of embryos of the cardiean shrimp Palaemon macrodectylus, which protect them from the pathogenic fungus Lagenidium callinectes. In present study, an antibacterial activity of isatin and its synthetic analogues were evaluated against different fouling bacteria in order to explore the structure activity relationships for the first time. The synthesized compounds along with parent isatin were tested against different ecologically relevant marine microorganisms by using the Kirby-Bauer disc diffusion method. Few synthetically modified isatin exhibited potent inhibitory activity at concentration of 2 μg/disc against Planococcus donghaensis, Erythrobacter litoralis, Alivibrio salmonicida, Vibrio furnisii. Overall, the modified analogues showed stronger activity than the parent marine natural product (isatin) and hence 1H-indole-2,3-dione scaffold has immense potential as future antibacterial/antifouling candidate.

Effectiveness of 'in-cast' pneumatic intermittent pedal compression for the pre-operative management of closed ankle fractures: a clinical audit

BACKGROUND

Timing of surgery for ankle fractures is largely dependent on the condition of the surrounding soft-tissues. This study aimed to determine the clinical effectiveness of a pre-operative in-cast artero-venous (AV) impulse device in the management of closed ankle fractures requiring surgery.

METHODS

A consecutive series of 64 closed ankle fractures were managed using the AV impulse system prior to surgery. Patients were compared to 73 consecutive closed ankle fractures managed surgically in the same unit immediately prior to the implementation of the AV impulse device study. Outcomes measured were time to surgery, length of hospital stay and surgical site infections.

RESULTS

Median length of time to surgery, hospital stay duration and surgical site infections were all significantly reduced in the study group as compared to the control group.

CONCLUSIONS

In-cast intermittent AV compression foot pumps in the pre-operative management of closed ankle fractures were associated with earlier surgery, earlier discharge and reduced complications.

Structure-function elucidation of a new α-conotoxin, Lo1a, from Conus longurionis

α-Conotoxins are peptide toxins found in the venom of marine cone snails and potent antagonists of various subtypes of nicotinic acetylcholine receptors (nAChRs). nAChRs are cholinergic receptors forming ligand-gated ion channels in the plasma membranes of certain neurons and the neuromuscular junction. Because nAChRs have an important role in regulating transmitter release, cell excitability, and neuronal integration, nAChR dysfunctions have been implicated in a variety of severe pathologies such as epilepsy, myasthenic syndromes, schizophrenia, Parkinson disease, and Alzheimer disease. To expand the knowledge concerning cone snail toxins, we examined the venom of Conus longurionis. We isolated an 18-amino acid peptide named α-conotoxin Lo1a, which is active on nAChRs. To the best of our knowledge, this is the first characterization of a conotoxin from this species. The peptide was characterized by electrophysiological screening against several types of cloned nAChRs expressed in Xenopus laevis oocytes. The three-dimensional solution structure of the α-conotoxin Lo1a was determined by NMR spectroscopy. Lo1a, a member of the α4/7 family, blocks the response to acetylcholine in oocytes expressing α7 nAChRs with an IC50 of 3.24 ± 0.7 μM. Furthermore, Lo1a shows a high selectivity for neuronal versus muscle subtype nAChRs. Because Lo1a has an unusual C terminus, we designed two mutants, Lo1a-ΔD and Lo1a-RRR, to investigate the influence of the C-terminal residue. Lo1a-ΔD has a C-terminal Asp deletion, whereas in Lo1a-RRR, a triple-Arg tail replaces the Asp. They blocked the neuronal nAChR α7 with a lower IC50 value, but remarkably, both adopted affinity for the muscle subtype α1β1δε.

A novel long-acting glucose-dependent insulinotropic peptide analogue: enhanced efficacy in normal and diabetic rodents

AIM

Glucose-dependent insulinotropic peptide (GIP) is an incretin hormone that is released from intestinal K cells in response to nutrient ingestion. We aimed to investigate the therapeutic potential of the novel N- and C-terminally modified GIP analogue AC163794.

METHODS

AC163794 was synthesized by solid-phase peptide synthesis. Design involved the substitution of the C-terminus tail region of the dipeptidyl peptidase IV (DPP-IV)-resistant GIP analogue [d-Ala(2) ]GIP(1-42) with the unique nine amino acid tail region of exenatide. The functional activity and binding of AC163794 to the GIP receptor were evaluated in RIN-m5F β-cells. In vitro metabolic stability was tested in human plasma and kidney membrane preparations. Acute insulinotropic effects were investigated in isolated mouse islets and during an intravenous glucose tolerance test in normal and diabetic Zucker fatty diabetic (ZDF) rats. The biological actions of AC163794 were comprehensively assessed in normal, ob/ob and high-fat-fed streptozotocin (STZ)-induced diabetic mice. Acute glucoregulatory effects of AC163794 were tested in diet-induced obese mice treated subchronically with AC3174, the exendatide analogue [Leu(14) ] exenatide. Human GIP or [d-Ala(2) ]GIP(1-42) were used for comparison.

RESULTS

AC163794 exhibited nanomolar functional GIP receptor potency in vitro similar to GIP and [d-Ala(2) ]GIP(1-42). AC163794 was metabolically more stable in vitro and displayed longer duration of insulinotropic action in vivo versus GIP and [d-Ala(2) ]GIP(1-42). In diabetic mice, AC163794 improved HbA1c through enhanced insulinotropic action, partial restoration of pancreatic insulin content and improved insulin sensitivity with no adverse effects on fat storage and metabolism. AC163794 provided additional baseline glucose-lowering when injected to mice treated with AC3174.

CONCLUSIONS

These studies support the potential use of a novel GIP analogue AC163794 for the treatment of type 2 diabetes.

Synthesis of (R)-norbgugaine and its potential as quorum sensing inhibitor against Pseudomonas aeruginosa

(R)-Bgugaine is a natural pyrrolidine alkaloid from Arisarum vulgare, which shows antifungal and antibacterial activity. In this Letter, we have accomplished the simple synthesis of norbgugaine (demethylated form of natural bgugaine) employing Wittig olefination and cat. hydrogenation as the key steps and its biological studies are reported for the first time. The synthesized norbgugaine was evaluated for inhibition of quorum sensing mediated virulence factors (motility, biofilm formation, pyocyanin pigmentation, rhamnolipid production and LasA protease) in Pseudomonas aeruginosa wherein swarming motility is reduced by 95%, and biofilm formation by 83%.

Interactions of amylinergic and melanocortinergic systems in the control of food intake and body weight in rodents

AIMS

Amylinergic and melanocortinergic systems have each been implicated in energy balance regulation. We examined the interactive effects of both systems using gene knockout and pharmacological approaches.

METHODS

Acute food consumption was measured in overnight fasted male wild-type (WT) and melanocortin-4 receptor (MC-4R) deficient rats and in male and female WT and amylin knockout mice (AmyKO). Changes in food intake, body weight and composition in male WT and MC-4R deficient rats and in male diet-induced obese (DIO) rats. Pharmacological treatments included either rat amylin, murine leptin and/or the MC-4R agonist, Ac-R[CEH-dF-RWC]-amide.

RESULTS

Amylin (10 µg/kg, IP) decreased food intake in WT but not in MC-4R deficient rats (30 and 60 min post-injection). Ac-R[CEH-dF-RWC]-amide (100 µg/kg, IP) suppressed food intake similarly in male WT and AmyKO, but was ineffective in female AmyKO. Amylin (50 µg/kg/day for 28 days) and leptin (125 µg/kg/day) synergistically reduced food intake and body weight in WT and MC-4R deficient rats to a similar extent. Amylin (100 µg/kg) combined with Ac-R[CEH-dF-RWC]-amide (100 µg/kg, IP) decreased acute food intake over 3 h to a greater extent than either agent alone in fasted mice. In DIO rats, additive anorexigenic, weight- and fat-lowering effects were observed over 12 days with the combination of rat amylin (50 µg/kg/day) and Ac-R[CEH-dF-RWC]-amide (2.3 mg/kg, SC injected daily).

CONCLUSIONS

Although amylin's acute anorexigenic effects are somewhat blunted in MC-4R deficiency and those of MC-4R agonism in amylin deficiency, these effects are surmountable with pharmacological administration lending therapeutic potential to combined amylin/melanocortin agonism for obesity.

Identifying the related compounds using electrospray ionization tandem mass spectrometry: bromotyrosine alkaloids from marine sponge Psammaplysilla purpurea

We have investigated extracts of marine sponge Psammaplysilla purpurea during three collections from Mandapam (Tamil Nadu, India) and Okha (Gujarat, India) and indentified two new bromotyrosine alkaloids, purpurealidin I (7) and J (8) using electrospray ionization tandem mass spectrometry (ESI-MS/MS). This sponge has tremendous chemical diversity of bromotyrosine alkaloids. Here we have used the proteomics approach in identifying related bromotyrosine alkaloids based on the predicated mass fragmentation pattern. The focus is on the examination of detailed product ion spectra of six known compounds that allowed identification of new compounds based on its mass fragmentation pattern. The isotopic pattern of the peaks for protonated molecules indicated the number of bromine atoms present in the molecule. During MS/MS studies, the most prominent product ion peak is for the presence of side chain propane with either free NH(2) or NHMe or Nme(2). The cleavage at C-C bond between oxime-amide carbonyl and amide-phenoxy moiety also gave characteristic product ions. The ESI-MS spectra for all three collections show that the bromotyrosine metabolites vary during different season and also geographical location. Although, some common metabolites were observed during the three collections. Thus, ESI-MS/MS is a method of choice in identifying the related compounds.

Antimicrobial activity of marine sponge Clathria indica (Dendy, 1889)

Sponges are sessile filter feeders that have developed efficient defense mechanisms against foreign invaders such as viruses, bacteria or eukaryotic organisms. Antimicrobial peptides are known as major components of the innate immune defense system in marine invertebrates. The aim of the present work was to study the antimicrobial properties of the Indian sponge Clathria indica with special reference to the identification of antimicrobial peptides. Crude methanolic extract and its chloroform, n-butanol and aqueous fractions were tested against 16 human pathogens which include eleven bacteria with four of them being multidrug resistant and five pathogenic fungi. All fractions showed effective antibacterial activity against common and multidrug-resistant Salmonella typhi and antifungal activity against C. albicans and C. neoformans. However, they were ineffective against Escherichia coli, Pseudomonas aeruginosa, Streptococcus pyogenes and Staphylococcus aureus. Chloroform fraction being the most potent among the fractions tested on chemical investigation was indicative of the presence of peptides as evidenced by ninhydrin positive spots on TLC and presence of peptide bonds by NMR. Its ESI-MS showed presence of several peptides in the range of m/z 850 to 980. Structure of three peptides has been tentatively assigned by ESI-MS/MS or tandem mass analysis, on the basis of the amino acid sequence established. The results clearly show that the sponge C. indica represent an interesting source of marine invertebrates-derived antimicrobial peptides in the development of new strategies to treat various infectious diseases.

A Hg (II) induced conformational change in penicillinase

Penicillinase (E.C. 3.5.2.6) from Bacillus cereus 569/H is inhibited by Hg(II). The inhibition is characterized by non-competitive kinetics and can be reversed by EDTA. A Hg(II) induced conformational change is indicated because: (1) The EDTA regenerated activity is unstable and is rapidly converted to an iodine-sensitive state, and (2) An irreversible change in the circular dichroism spectrum at 222 nm is found.

Use of Fourier Transform Infrared (FTIR) spectroscopy to study cadmium-induced changes in Padina tetrastromatica (Hauck)

The aim of this study is to adopt the approach of metabolic fingerprinting through the use of Fourier Transform Infrared (FTIR) technique to understand changes in the chemical structure in Padina tetrastromatica (Hauck). The marine brown alga under study was grown in two different environmental conditions; in natural seawater (P. tetrastromatica (c)) and in seawater suplemented with 50 ppm of cadmium (P. tetrastromatica (t)) for a three-week period in the laboratory. The second derivative, IR specrum in the mid-infrared region (4000-400 cm(-1)) was used for discriminating and identifying various functional groups present in P. tetrastromatica (c). On exposure to Cd, P. tetrastromatica (t) accumulated 412 ppm of Cd and showed perturbation in the band structure in the mid-IR absorption region. Variation in spectral features of the IR bands of P. tetrastromatica (untreated and treated) suggests that cadmium ions bind to hydroxyl, amino, carbonyl and phosphoryl functionalities. This was attributable to the presence of the following specific bands. A band at 3666 cm(-1) in untreated P. tetrastromatica (c) while a band at 3560 cm(-1) in Cd-treated P. tetrastromatica (t) due to non bonded and bonded O-H respectively. Similarly, non bonded N-H for P. tetrastromatica (c) showed two bands at 3500 cm(-1) and 3450 cm(-1) due to the N-H stretching vibrations and a band at 1577 cm(-1) due to N-H bending vibrations, while an intense band at 3350 cm(-1) due to bonded N-H stretching vibrations and at 1571 cm(-1) due to bending vibrations was observed for Cd-treated P. tetrastromatica (t). Involvement of ester carbonyl group is characterized by the presence of a band at 1764 cm(-1) in untreated P. tetrastromatica (c) while the Cd-treated P. tetrastromatica (t) showed the band at 1760 cm(-1). The intensity of the band at 1710 cm(-1) in the control samples decreased drastically after cadmium treatment indicating carbonyl of COOH to be involved in metal chelation. A band at 1224 cm(-1) for untreated P. tetrastromatica (c) and at 1220 cm(-1) for Cd-treated P. tetrastromatica (t) is indicative of the involvement of phosphoryl group in metal binding. Several other such changes were also evident and discussed in this paper. Based on our observation, FTIR technique proves to be an efficient tool for detecting structural changes and probable binding sites induced by the presence of a metal pollutant, cadmium, in the marine environment.

Use of Fourier Transform Infrared (FTIR) Spectroscopy to Study Cadmium-Induced Changes in Padina Tetrastromatica (Hauck)

The aim of this study is to adopt the approach of metabolic fingerprinting through the use of Fourier Transform Infrared (FTIR) technique to understand changes in the chemical structure in Padina tetrastromatica (Hauck). The marine brown alga under study was grown in two different environmental conditions; in natural seawater ( P. tetrastromatica (c)) and in seawater suplemented with 50 ppm of cadmium ( P. tetrastromatica (t)) for a three-week period in the laboratory. The second derivative, IR specrum in the mid-infrared region (4000-400 cm-1) was used for discriminating and identifying various functional groups present in P. tetrastromatica (c). On exposure to Cd, P. tetrastromatica (t) accumulated 412 ppm of Cd and showed perturbation in the band structure in the mid-IR absorption region. Variation in spectral features of the IR bands of P. tetrastromatica (untreated and treated) suggests that cadmium ions bind to hydroxyl, amino, carbonyl and phosphoryl functionalities. This was attributable to the presence of the following specific bands. A band at 3666 cm-1 in untreated P. tetrastromatica (c) while a band at 3560 cm-1 in Cd-treated P. tetrastromatica (t) due to non bonded and bonded O-H respectively. Similarly, non bonded N-H for P. tetrastromatica (c) showed two bands at 3500 cm-1 and 3450 cm-1 due to the N-H stretching vibrations and a band at 1577cm-1 due to N-H bending vibrations, while an intense band at 3350 cm-1 due to bonded N-H stretching vibrations and at 1571 cm-1 due to bending vibrations was observed for Cd-treated P. tetrastromatica (t). Involvement of ester carbonyl group is characterized by the presence of a band at 1764 cm-1 in untreated P. tetrastromatica (c) while the Cd-treated P. tetrastromatica (t) showed the band at 1760 cm-1. The intensity of the band at 1710 cm-1 in the control samples decreased drastically after cadmium treatment indicating carbonyl of COOH to be involved in metal chelation. A band at 1224 cm-1 for untreated P. tetrastromatica ( c) and at 1220 cm-1 for Cd-treated P. tetrastromatica (t) is indicative of the involvement of phosphoryl group in metal binding. Several other such changes were also evident and discussed in this paper. Based on our observation, FTIR technique proves to be an efficient tool for detecting structural changes and probable binding sites induced by the presence of a metal pollutant, cadmium, in the marine environment.

Meaningful differences in maternal smoking behaviour during pregnancy: implications for infant behavioural vulnerability

BACKGROUND

Smoking during pregnancy has been consistently associated with risk of problem behaviour in offspring. There is debate about whether this association reflects a teratological effect or is a marker for problematic maternal characteristics. We test these "competing" hypotheses by examining whether (1) exposure is associated with an early risk pathway by testing its association with infant temperamental difficultness, and (2) whether pregnancy quitting is associated with an early protective pathway, testing its association with easy infant temperament.

METHODS

We used the 9-month-old sweep of the Millennium Cohort Study, a cohort of over 18,000 infants born in 2000-2. Mothers were classified as pregnancy non-smokers, quitters and light or heavy smokers. Temperamental positive mood, receptivity to novelty and regularity were assessed with the Carey Infant Temperament Scale.

RESULTS

Pregnancy quitters had infants with the highest scores of easy temperament and heavy smokers had infants with the lowest scores (F = 28.51, p<0.001). Pregnancy smoking also predicted difficult temperament: heavy smoking was associated with increased risk of low positive mood (OR = 1.17, p = 0.09). In contrast, pregnancy quitting exerted a protective effect with decreased risk of distress to novelty (OR = 0.79, p<0.01) and irregularity (OR = 0.89, p = 0.02) in these infants.

CONCLUSIONS

Pathways from pregnancy smoking to offspring behaviour are complex and multi-determined. These findings suggest that both exposure and maternal characteristics associated with pregnancy smoking status contribute to offspring behavioural patterns. Research that characterises differences between quitters and persistent smokers and examines the role of these differences in prediction of early vulnerabilities and problems in adaptation over time will be important for elucidating these pathways.

Anti-platelet agents and surgical delay in elderly patients with hip fractures

PURPOSE

To assess the risk of surgical delay in elderly hip fracture patients on anti-platelet agents.

METHODS

Records of 180 patients aged over 65 years with either an intertrochanteric or femoral neck fracture were reviewed. The clopidogrel group included 10 patients on clopidogrel alone and 11 others on clopidogrel and aspirin, whereas the control group included 69 on aspirin alone and the remaining 90 not on any anti-coagulants. The 2 groups were compared with regard to time to surgery, preoperative American Society of Anesthesiologists (ASA) score, pre- and post-operative haemoglobin levels, in-patient complication rates, duration of hospital stay, and 30-day mortality.

RESULTS

In the clopidogrel and control groups respectively, the mean times to surgery were 7.2 and 2.1 days (p=0.03, t-test), the mean preoperative ASA scores were 3.35 and 2.8 (p=0.29, t-test), the mean preoperative haemoglobin levels were 119 and 115 g/l (p=0.5, t-test), the mean postoperative haemoglobin levels were 98 and 96 g/l (p=0.68, t-test), the mean durations of hospital stay were 7.4 and 3.1 days (p=0.02, t-test). The 30-day mortalities were 6/21 (29%) and 6/159 (4%) [p=0.0003, Fisher's exact test].

CONCLUSION

Surgical delay in elderly patients on anti-platelet agents with hip fracture was associated with higher mortality. Despite the risk of increased blood loss, we suggest early surgery be carried out by an experienced surgeon to expedite the operating time. Pooled platelets should be given intravenously one to 2 hours preoperatively.

Rethinking research in breast-feeding: a critique of the evidence base identified in a systematic review of interventions to promote and support breast-feeding

Objective

To appraise critically the relevance and value of the evidence base to promote and support the duration of breast-feeding, with a specific focus on disadvantaged groups.

Design

A systematic review was conducted of intervention studies relevant to enhancing the duration of breast-feeding; topics included public health, public policy, clinical issues, and education, training and practice change. A systematic search was conducted. Eighty studies met the inclusion criteria. Data were systematically extracted and analysed. Full results and recommendations are reported elsewhere. Here a critique of the evidence base – topics, quality and gaps – is reported.

Results

Many studies were substantially methodologically flawed, with problems including small sample sizes, inconsistent definitions of breast-feeding and lack of appropriate outcomes. Few were based on relevant theory. Only a small number of included studies (10%) were conducted in the UK. Very few targeted disadvantaged subgroups of women. No studies of policy initiatives or of community interventions were identified. There were virtually no robust studies of interventions to prevent and treat common clinical problems, or of strategies related to women's health issues. Studies of health professional education and practice change were limited. Cost-effectiveness studies were rare.

Conclusions

Policy goals both in the UK and internationally support exclusive breast-feeding until 6 months of age. The evidence base to enable women to continue to breast-feed needs to be strengthened to include robust evaluations of policies and practices related to breast-feeding; a step change is needed in the quality and quantity of research funded.

New caulerpenyne-derived metabolites of an Elysia sacoglossan from the South Indian coast

Chemical analysis of the secondary metabolite pattern of the sacoglossan mollusc Elysia cf. expansa, collected along South Indian coasts, showed the presence of the typical Caulerpa-derived sesquiterpene caulerpenyne (1) and two new minor co- occurring metabolites, the compounds dihydrocaulerpenyne (4) and expansinol (5). The chemical characterization of these molecules, structurally related to 1, is reported.

Glycolipids from the red alga Chondria armata (Kütz.) Okamura

Three distinct fractions containing polar glycolipids (PF(1-3)) were isolated from the chloroform soluble fraction of crude methanolic extract of red alga Chondria armata (Kütz.) Okamura on gel chromatography over Sephadex LH20. Their structure was elucidated by multidimensional nuclear magnetic resonance (NMR) techniques like 1H, 1H correlation spectroscopy (COSY), 1H, 1H total COSY (TOCSY), 1H, 13C heteronuclear multiple quantum coherence (HMQC), and 1H, 13C heteronuclear multiple bond correlation (HMBC) complemented by electrospray ionization mass spectrometry (ESI-MS) in the positive ion mode. The coupling constant of the anomeric proton in 1H NMR spectrum and sign of rotation indicated an exclusive configuration of the sugar molecules in the glycerolipids. Major glycolipids were identified as (2R)-2-O-(5,8,11,14-eicosatetranoyl)-3-O-alpha-d-galactopyranosyl-sn-glycerol (GL2), its pentacetate (GL1), and (2R)-1-O-(palmitoyl)-2-O-(5,8,11, 14,17-eicosapentanoyl)-3-O-beta-d-galactopyranosyl-sn-glycerol (GL3). Each was methanolysed to give the same galactosylglycerol which on ESI-MS provided a pseudomolecular ion at m/z 309 representing deacylated glycolipid with the sodiated sugar moiety. Additionally, six minor glycolipids were also identified on the basis of ESI-MS. These include a 1,2-di-O-acyl-3-O-(acyl-6'-galactosyl)-glycerol (GL1a), sulfonoglycolipids 2-O-palmitoyl-3-O-(6'-sulfoquinovopyranosyl)-glycerol (GL2a) and its ethyl ether derivative (GL2b), 1-oleoyl-2-palmitoyl-3-O-galactosyl glycerol (GL3a), and 1,2-diacyl phosphatidyl glycerol (GL3b). GL1, GL1a, and GL2b are new to the literature. The novelty of the remaining identified compounds lies in the diversity of their fatty acid composition. Antimicrobial properties of these glycolipids against pathogens were evaluated. The yeast Candida albicans and the bacteria Klebsiella sp. were as sensitive as the standard Nystatin and antibiotic Streptomycin against PF3. Considerable activity was expressed by the same metabolite against the fungus Cryptococcus neoformans as compared to the control. Weak activity against the bacteria Shigella flexineri and Vibrio cholerae and the fungus Aspergillus fumigatus was also observed. Fraction PF2 was weakly active against some strains whereas all of them were resistant to its acetyl derivative PF1. Antimicrobial activity of glycolipids is being reported here for the first time.

Determination of geometric orientation of adsorbed cinchonidine on Pt and Fe and quiphos on Pt nanoclusters via DRIFTS

Platinum nanoclusters modified with cinchonidine have been employed as 'quasi-homogeneous' catalysts for the hydrogenation of ethyl pyruvate and have demonstrated exceptional activities while the ee's of these systems are currently inferior to the traditional Pt/Al2O3 heterogeneous system. For the bulk systems it has been shown that the orientation of the modifier on the metal surface is a critical parameter influencing catalytically induced enantioselectivity. It has been speculated that the lower observed ee's for the nanocluster systems are a result of the modifier assuming an orientation unfavorable for inducing enantioselectivity due to the lack of large numbers of planar metal atoms. Using DRIFTS (diffuse reflectance infra-red Fourier transform spectroscopy) analysis of samples together with geometry optimization and IR modelling we have studied the orientation of cinchonidine on Pt and Fe nanoclusters and additionally the man-made ligand quiphos on Pt nanoclusters. It has been determined that cinchonidine can adsorb on Pt and Fe nanoclusters in both 'flat' and 'tilted' modes, while quiphos can be adsorbed on Pt only via the 'pi-bonded' mode. These studies thus provide an insight into modifier orientation on nanocluster surfaces that can be extended to a wide range of potential modifiers and facilitate a better understanding of the origin of enantioselectivity with these 'quasi-homogeneous' catalyst systems.

Improving services for disadvantaged childbearing women

BACKGROUND

Tackling health inequalities is high on the political agenda of the Labour government. The government wants to reduce inequalities through policies based on evidence, the health of childbearing women and their babies being priority areas for action. National Service Frameworks (NSFs) are being set up to ensure high quality services for all groups. The External Working Group looking into maternity services for the Children's NSF seeks evidence upon which to plan strategies for all women, while focusing attention on the most disadvantaged. Wide differentials are noted between high- and low-income groups in the outcomes of pregnancy and the health of babies. The worst outcomes appear to be concentrated in small subgroups of disadvantaged women.

AIM

To report on a review of studies of interventions improving perinatal outcomes for disadvantaged women, to inform policy and practice around the organization and delivery of statutory services in the UK.

METHOD

We searched six relevant databases for reviews, intervention studies, audits and descriptions of services reporting outcomes for disadvantaged groups of women, published between 1990 and 2003. Synthesis was performed around what works and what does not work. Gaps in the evidence base were identified.

RESULTS

We found limited evidence of effective and promising interventions for childbearing women from minority ethnic groups, women experiencing domestic violence, women with mental health illness and HIV infected women. Few studies were well-designed or powered to detect effectiveness. There were no studies of interventions for women prisoners, homeless women and travellers.

CONCLUSIONS

Searching for intervention studies primarily by participant subgroup has brought in evidence from few well-designed studies on which to plan policy. Combining this approach with searching for intervention studies addressing behaviour like smoking, and needs like social support, may provide further evidence to tackle inequalities in the perinatal period.

New acetogenin peroxides from the Indian sponge Acarnus bicladotylota

Two new cyclic peroxides (1 and 2) and the known metabolite 3 have been found in the organic extract of the Indian sponge Acarnus bicladotylota. The structure of the new products has been assured by chemical and spectroscopic methods. The absolute stereochemistry of 1-3 has been determined by Mosher's method on the semisynthetic derivative 4.

New scalaranes from the nudibranch Glossodoris atromarginata and its sponge prey

Two new scalaranes (1 and 2) have been isolated from the dorid nudibranch Glossodoris atromarginataand its prey. The structures were deteremined by spectral techniques and confirmed by chemical methods. Compounds 1 and 3 showed selective cytotoxic activity against human thyroid carcinoma.

Volvatellin, caulerpenyne-related product from the sacoglossan volvatella sp

Volvatellin (4) is a highly unstable terpene isolated from the extracts of the Indian opisthobranch mollusk Volvatella sp. The structure and the relative stereochemistry of 4 were determined by NMR methods. The paper also describes a hypothetical biosynthesis of 4 starting from the alga-derived caulerpenyne.

Foot deformities in children with cerebral palsy

Clinical observation suggests that deformities of the foot and ankle are common in children with cerebral palsy. Two hundred children with cerebral palsy attending the Central Remedial Clinic were examined and photographed. The children had no previous surgical intervention and were between 1.5 and 19 years of age. Deformities were assessed and related to the type of cerebral palsy and mobility status.

Expression and protective effects of urocortin in cardiac myocytes

Reverse transcription PCR showed that mRNA encoding the CRH-like molecule, urocortin, is expressed in a rat cardiac myocyte cell line and in primary cultures of cardiac myocytes. Identity of the amplified with the published sequence was established by restriction mapping and direct sequencing. Expression of urocortin mRNA was increased 12-18 h after thermal injury. Urocortin peptide protected cardiac myocytes from cell death induced by hypoxia. The data suggest that urocortin is an endogenous cardiac myocyte peptide which modulates the cellular response to stress.

Somatic embryogenesis inGnetum ula Brongn. (Gnetum edule) (Willd) Blume

Somatic embryos ofGnetum ula (Gnetum edule) an endangered gymnosperm closely related to the angiosperms have been induced in vitro. Megagametophyte tissue with immature embryos was cultured on Murashige and Skoog medium. A mucilaginous, translucent embryogenic callus was obtained with 5 mg/l BA. Callus induced with 2,4-D was non-embryogenic. The embryogenic callus in liquid half strength Murashige and Skoog medium without inorganic nitrates supplemented with 2.5 g/l casein hydrolysate and 0.5 g/l L-glutamine gave rise to immature embryos. The embryos matured when treated with 60 g/l sucrose and 10 mg/l abscisic acid.

Hypokalemia after normal doses of neubulized albuterol (salbutamol)

The cases of two asthmatic patients who became hypokalemic after inhalation of normal doses of albuterol are presented. One patient was symptomatic and the other had only electrocardiographic changes. Both were treated successfully with oral potassium. Albuterol-induced hypokalemia and its potential cardiac toxicity are discussed briefly.

The subcostal nerve (ouch!): anatomical awareness in Salter's innominate osteotomy

The identification of the lateral cutaneous branch of the subcostal nerve supplying the anterior gluteal region while using the modified Smith-Petersen approach in performing Salter's innominate osteotomy has not been described previously. Following cadaveric dissection in six specimens and after performing routine Salter's innominate osteotomy using the modified Smith-Petersen approach in five patients, we found consistently that the lateral cutaneous branch of the subcostal nerve crossed the iliac crest between 2 and 5 cm posterior to the anterior superior iliac spine. This important accidental finding has led us to take care in identifying and protecting this nerve from any undue injury that could cause blunting of sensation in the anterior gluteal region.

Bioactivity of marine organisms: Part VII--Effect of seaweed extract on central nervous system

Alcohol extracts of marine algae (Rhodophyceae, Phaeophyceae and Chlorophyceae) were screened for their effect on central nervous system. Of 69 species investigated 8 appeared biologically active, 6 being CNS stimulant and two depressant, sites and dates of collection are given.

Neuropeptide Y immunoreactivity in the spleen and thymus of normal rats and following adjuvant-induced arthritis

Immunoreactive neuropeptide Y (irNPY) was detected by radioimmunoassay within the rat thymus and spleen. Total spleen and thymus irNPY contents in control animals were 77 +/- 3 ng and 23 +/- 1 ng respectively (means +/- S.E.M., n = 10). Total tissue contents of irNPY 14 days following bilateral adrenalectomy or induction of inflammatory arthritis were not significantly altered compared to controls. Most spleen irNPY coeluted with synthetic NPY after reversed-phase high-performance liquid chromatography, but two peaks of irNPY were detected in thymic extracts. This suggests that NPY may be differentially expressed in tissues of the immune system.

Occupational asthma caused by himic anhydride

Acid anhydride compounds are reactive chemicals that have been previously associated with immunoglobulin E (IgE) mediated occupational asthma. Twenty workers with exposure to himic anhydride powder used for the manufacture of a synthetic flame retardant were questioned about respiratory symptoms. The study was initiated after one individual from the plant developed asthma. A test for serum-specific IgE to human serum albumin conjugates of himic anhydride, phthalic anhydride, hexahydrophthalic anhydride and trimellitic anhydride was performed for seven workers with respiratory symptoms associated with himic anhydride exposure. Three of the seven symptomatic workers who reported wheezing at work exhibited elevated specific IgE to two or more acid anhydride-human serum albumin conjugates. Radioallergosorbent inhibition studies performed with sera containing high levels of himic anhydride-human serum albumin specific IgE from a symptomatic worker demonstrated cross-allergenicity between himic anhydride-human serum albumin and hexahydrophthalic anhydride-human serum albumin allergenic determinants. This study demonstrated that himic anhydride can elicit IgE-mediated sensitization in the workplace.

Heterogeneity of specific-IgE responses in workers sensitized to acid anhydride compounds

Acid anhydride compounds cause IgE-mediated respiratory sensitization in the workplace. In this study reaginic responses in four workers sensitized to phthalic anhydride (PA), hexahydrophthalic (HHPA), or himic anhydride (HA) were determined by direct RAST by use of PA-human serum albumin (HSA), HPPA-HSA, and HA-HSA methylcellulose disc substrates. RAST inhibition of binding to anhydride-HSA substrates was done with various concentrations of sodium salts, lysine, and HSA conjugates of PA, HHPA, HA, and trimellitic anhydride (TMA) in order to characterize cross-reactivity and specificity of humoral responses in these workers. Molar concentrations of anhydride bound to lysine and HSA carriers were assayed by protein hydrolysis followed by gas chromatographic analysis. Significant direct RAST binding against PA-HSA, HHPA-HSA, and HA-HSA was found in all four workers. PA-HSA-IgE binding in one PA-sensitive worker (no. 1) was inhibited significantly by PA-HSA alone and not by sodium PA or PA lysine. In contrast, another PA-sensitized worker (no. 2) exhibited 50% inhibition of PA-HSA binding by PA-HSA (1 X 10(-9) M), PA-lysine (7 X 10(-8) M), and NaPA (1 X 10(-7) M); no inhibition of PA-HSA by heterologous HHPA-, HA-, or TMA-inhibitory reagents was found in either of the PA workers. RAST binding to HHPA-HSA in the HHPA-sensitive worker was inhibited by HHPA-HSA alone.(ABSTRACT TRUNCATED AT 250 WORDS)

An acquired abnormal fibrinogen associated with thromboembolic disease and pseudotumor cerebri

An abnormal fibrinogen was found in a patient associated with disabling recurrent phlebitis and pulmonary emboli, pseudotumor cerebri, gout and endometriosis. The fibrinogen is characterized by (1) abnormal side-to-side and end-to-end polymerization, (2) abnormal fibrinopeptide release, (3) a delayed gamma-gamma dimerization of the non cross-linked fibrin, (4) a pH optimum of 7--7.8, and (5) a deviation from normal amino acid composition with regard to lysine, aspartic acid, glutamic acid and serine. Since no defect has been found in any of her three children, and since the prothromin and partial thromboplastin times vary from time to time, it is assumed that the defect is acquired. Liver disease, usually associated with acquired abnormal fibrinogen, has been excluded as an etiological cause since liver function tests and biopsy are completely normal.

Measurement of nucleotide pools in platelets using high pressure liquid chromatography

We have devised an improved high pressure liquid chromatographic technique whereby serotonin, nucleosides, cyclic nucleotides, namely cAMP and cGMP, and 5'mono-, 5'di-, and 5'tri-nucleotides can be analyzed. The cyclic nucleotides have been measured in picomolar quantities. All nucleotides can be quantitated in a single step separation in 75 min using a 0.0015 M phosphoric acids vs. 1M pH 4.8 ammonium phosphate gradient. 5/10 ml of platelet-rich plasma furnishes an adequate sample for complete analysis. Nucleotide levels in platelets from 16 normal donors expressed in 10(11) platelets are as follows: cAMP, 6.32 (4.15) nanomoles and AMP, 0.32 (0.14); ADP, 2.48 (0.67); ATP 3.78 (0.68); GDP 0.38 (0.07) and GTP, 0.45 (0.07) micromoles. ADP and ATP values are lower than those previously published. However, the total nucleotide level approaches published values. Upon aggregation with thrombin, approximately 50% of ADP and 40% ATP is releaseed. Release is complete by 2 min. Thrombin is the most potent releasing agent with collagen and ADP occupying an intermediate role and epinephrine being the least effective. Upon aggregation cyclic AMP levels diminish along the other nucleotides. Patients with asthma showed depression of ADP, ATP, GDP and GTP levels.

Quinazolines as inhibitors of dihydrofolate reductase. 3. Analogs of pteroic and isopteroic acids

A series of 19 quinazoline analogs of pteroic and isopteroic acid was prepared with particular emphasis being placed upon carboxylic acid esters. Each compound was evaluated as an inhibitor of the dihydrofolate reductases from rat liver as well as from Streptococcus faecium. Several of the more potent inhibitors were found to be inactive against L1210 leukemia in mice at low dose levels and were lethal to mice at 100 mg/kg. Six compounds were also evaluated for antimalarial activity against Plasmodium berghei in mice. Three of these were found to be curative at higher levels, while the remaining compounds were found to be toxic.