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Popular Articles

How Microbial Neighbors Settle Differences
Even microbes are governed by the principle of supply and demand - at least at the genetic level. Not all of their gene products, the blueprints for proteins, are required at all times. That means most of their genes only become active when they are needed, as is the case in higher organisms. In the simplest case, a transcription factor will activate the gene in question at the right time. Genes that are regulated in a somewhat more complex manner, on the other hand, are kept inactive by a repressor that is removed only when the gene is needed. Which of these two regulation mechanisms will develop is a question of demand, along the lines of a "use-it-or-lose-it" principle: if genes are frequently active, then, as a rule, they will be directly induced. Genes that encode more rarely used proteins, on the other hand, tend to be kept inactive by repressors. LMU physicist Ulrich Gerland and Professor Terence Hwa of the University of California have now demonstrated using computer simulations and theoretical analyses that another - indeed opposing - principle also comes into play: "wear-and-tear". According to this principle, direct activation can lead to harmful changes. "Which of the two principles prevails depends on evolutionary criteria such as the population size and the periods over which environmental changes take place," says Gerland. "Our study may serve as a useful basis for more detailed studies of the evolution of regulatory systems." (PNAS Early Edition, 22 Mai 2009)
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Schering-Plough Announces U.S. Filing Of Mometasone Furoate/Formoterol Fumarate Combination For The Maintenance Treatment Of Asthma
Schering-Plough announced that a New Drug Application (NDA) for a fixed-dose combination of mometasone furoate and formoterol fumarate has been filed in the United States and accepted for review by the U.S. Food and Drug Administration (FDA). Schering-Plough is seeking marketing approval from the FDA of the mometasone furoate/formoterol fumarate combination for the maintenance treatment of asthma in patients 12 years of age and older.
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New Support For A Controversial Mechanism Underlying An Irregular Heart Beat
The most common form of human heart beat irregularity (atrial fibrillation) can be fatal if left untreated. It has been suggested that it is caused, in part, by calcium leaking from a cellular store in heart cells, potentially through the RyR2 channel, although this mechanism remains controversial. However, a team of researchers at Baylor College of Medicine, Houston, and Dresden University of Technology, Germany, has provided support for this hypothesis by showing that the protein CaMKII can enhance RyR2-mediated calcium leak, promoting atrial fibrillation in mice.
Diagnostics

ACOG Issues Revision Of Labor Induction Guidelines

Revised guidelines on when and how to induce labor in pregnant women were issued by The American College of Obstetricians and Gynecologists (ACOG). The guidelines provide physicians with guidance regarding which induction methods may be most appropriate under particular circumstances, as well as the safety requirements, and risks and benefits of the different methods. ACOG"s Practice Bulletin "Induction of Labor" is published in the August 2009 issue of Obstetrics & Gynecology. The rate of labor induction in the US has more than doubled since 1990. In 2006, more than 22% (roughly 1 out of every 5) of all pregnant women had their labor induced. The goal of labor induction is to artificially stimulate uterine contractions so that pregnant women can deliver vaginally. As with all procedures, the risks must be weighed against the benefits to the woman and the fetus. "There are certain health conditions, in either the woman or the fetus, where the benefit of inducing labor is clear-cut," says Susan Ramin, MD, from the University of Texas Medical School in Houston who helped lead the development of ACOG"s Practice Bulletin. "And, there are some nonmedical situations in which induction also may be prudent, for instance, in rural areas where the distance to the hospital is just too great to risk waiting for spontaneous labor to happen at home." In circumstances like these, the ACOG recommendations say the gestational age of the fetus should be determined to be at least 39 weeks or that fetal lung maturity must be established before induction. Cervical ripening is the first component to labor induction. If the cervix is not sufficiently dilated, then drugs or mechanical cervical dilators should be used to ripen the cervix before labor is induced. Once the cervix is dilated, labor can be induced with oxytocin, membrane stripping, rupture of the amniotic membrane, or nipple stimulation. Misoprostol, a medication for peptic ulcers, is a commonly used off-label drug that both ripens the cervix and induces labor. The ACOG guidelines indicate that inducing labor with misoprostol should be avoided in women who have had even one prior cesarean delivery due to the possibility of uterine rupture (which can be catastrophic). According to ACOG, there are a number of health conditions that may warrant inducing labor but physicians should take into account maternal and infant conditions, cervical status, gestational age, and other factors. Some examples in which labor induction is indicated include (but are not limited to) gestational or chronic hypertension, preeclampsia, eclampsia, diabetes, premature rupture of membranes, severe fetal growth restriction, and postterm pregnancy. "There are certain situations where labor induction is contraindicated," says Dr. Ramin. These situations include (but are not limited to) transverse fetal position, umbilical cord prolapse, active genital herpes infection, placenta previa, and women who have had a previous myomectomy (fibroid removal) from the inside of the uterus, according to ACOG. "A physician capable of performing a cesarean should be readily available any time induction is used in the event that the induction isn"t successful in producing a vaginal delivery," notes Dr. Ramin. Although rare, there are potential complications with some methods of labor induction. "These guidelines will help physicians utilize the most appropriate method depending on the unique characteristics of the pregnant woman and her fetus." Practice Bulletin #107, "Induction of Labor," is published in the August 2009 issue of Obstetrics & Gynecology. American College of Obstetricians and Gynecologists


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