While prescribing in pregnancy, the physician is confronted with the problem of alleviating the mothers symptoms and ensuring that no or minimal harm is produced in the unborn. Unfortunately, the rising trend of drug consumption during this period appears often to be in near-disregard to the unintended recipient “the unborn baby”. This article examines various aspects that have to be considered before deciding on the appropriate therapy in a pregnant (possibly pregnant) woman as well as in lactating mothers.
This review presents basic aspects of placental morphology with particular reference to the regional specialization of human placental tissues. Intrauterine visualization of the placenta is now possible with new non-invasive methods. Echotomographic ultrasound images of the placenta in vivo and in vitro are of the greatest value for clinical and pathological diagnosis. X-ray computed tomography, though it cannot be applied to pregnant women, is invaluable for the study of circulatory and pathologic changes in the placenta isolated post partum. Nuclear magnetic resonance imaging is another useful adjunct not only for placental localization but also to detect changes of placental morphology with an accuracy almost as good as ultrasonography. Fourier-transform spectroscopy now offers a unique opportunity to obtain computed biochemical data on the metabolic evolution of the human placenta.
Recent interest in biofuels and bio-refineries has been building upon the technology of biomass gasification. This technology developed since the 1980s in three periods, but failed to break through. We try to explain this by studying the technological development from a quasi-evolutionary perspective, drawing upon the concepts of technological paradigms and technological trajectories. We show that the socio-economic context was most important, as it both offered windows of opportunity as well as provided direction to developments. Changes in this context resulted in paradigm shifts, characterized by a change in considered end-products and technologies, as well as a change in companies involved. Other influences on the technological trajectory were firm specific differences, like the focus on a specific feedstock, scale and more recently biofuels to be produced. These were strengthened by the national focus of supporting policies, as well as specific attention for multiple technologies in policies of the USA and European Commission. Over each period we see strong variation that likely benefitted the long term development of the technology. Despite policy efforts that included variation and institutionalization, our case shows that the large changes in socio-economic context and the technological challenges were hard to overcome.
Although few psychotropic drugs are known to be teratogenic or to have adverse effects on the developing fetus or neonate, no psychotropic drug is of proven safety. It is therefore very important that psychotropic medication should not be prescribed lightly during pregnancy or lactation and that such drugs should be prescribed only where there are positive indications for their use. Close collaboration between obstetrician and psychiatrist is recommended before treatment of a mental illness with psychotropic medication. Breast feeding should not routinely be suspended in mothers who require psychotropic medication. There is an adequate range of psychotropic drugs available to safely treat the pregnant or lactating woman who is mentally ill.
DNA-damage response of cutaneous interfollicular melanocytes to fractionated radiotherapy was investigated by immunostaining of tissue sections from punch biopsies collected before, during, and after the treatment of patients for breast cancer. Our clinical assay with sterilized hair follicles, excluded the migration of immature melanocytes from the bulge, and highlighted interfollicular melanocytes as an autonomous self-renewing population. About thirty percent are immature. Surrounding keratinocytes induced and maintained melanocyte differentiation as long as treatment was ongoing. Concomitant with differentiation, melanocytes were protected from apoptosis by transient upregulation of Bcl-2 and CXCR2. CXCR2 upregulation also indicated the instigation of premature senescence, preventing proliferation. The stem cell factor BMI1 was constitutively expressed exclusively in interfollicular melanocytes and further upregulated upon irradiation. BMI1 prevents apoptosis, terminal differentiation, and premature senescence, allowing dedifferentiation post-treatment, by suppressing the p53/p21-and p16-mediated response and upregulating CXCR2 to genotoxic damage. The pre-treatment immature subset of interfollicular melanocytes was restored after the exposure ended.
