Over the past 40 years researchers have sought to define and describe the pathobiology, etiologic factors, clinical characteristics, diagnostic methods, pathologic sequelae, and effective treatments for bacterial vaginosis. Bacterial vaginosis (BV) is increasingly recognized as directly related to a number of serious obstetrical and gynecologic complications. The name bacterial vaginosis was selected to reflect the characteristic vaginal discharge and the polymicrobial nature of the condition as well as the relative absence of an inflammatory response. Three methods used to detect BV were compared with the standard clinical diagnosis proposed by Amsel. In a uniquely detailed cross-sectional study of the microbiology of acute salpingitis, Soper and colleagues identified vaginal fluid Gram stain findings of BV among 61.8% of women with laparoscopically confirmed pelvic inflammatory disease. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. Several effective treatments for BV are currently available.

Objectives We evaluated the ability of population attributable fraction (PAF) assessments to alter significant modifiable risks for low birthweight (LBW) and the impact of high altitude as a risk for LBW in Colorado. Methods Logistic regression analysis of birth certificate parameters in 1995–1997 identified risk factors for PAF assessment. PAF for birth at high altitude, multiple births, and LBW in singleton births were determined. Subsequent analysis of singleton LBW risks, using number needed to treat (NNT) analysis, estimated how elimination of major modifiable risk factors could reduce LBW in the study population. Public health interventions were initiated and PAF analysis conducted 12 years afterward to determine the effect of interventions. Results PAF in singleton births revealed low maternal weight gain in pregnancy and maternal smoking as the greatest modifiable attributable risk factors for LBW (12.7/12.5 %, respectively, in 1995–1997 and 12.9/7.1 % in 2007–2009). Significant interaction between these variables resulted in PAF of 34.4 % when the two occurred together in 1995–1997, decreasing to 19.4 % in 2007–2009. NNT analysis of singleton births in 1995–1997 revealed that eliminating low maternal weight gain, smoking, late prenatal care in all women and interpregnancy intervals <1 year in multiparous women reduced LBW by 46.5 %. The respective proportional reductions in PAF of 40.3 and 46.3 % for maternal smoking and weight gain/smoking interaction were associated with a 1.4 % LBW reduction in singleton births between the two study periods. Conclusions for Practice PAF and NNT analyses are valuable tools to predict intervention targets to lower LBW.

Objective. DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. Design. This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. Setting. Denver Health Hospitals and Clinics, Denver, Colorado, USA. Population. 871 pregnant women aged 18-40 were recruited between16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. Methods. Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. Main Outcome Variable. Gestational length. Results. Gestational length was significantly increased by 4.0-4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7%) in those supplemented with DHA (combined 300 and 600 mg/day) was significantly lower than in controls. Conclusion. Nutrition education or supplementation with DHA can be effective in increasing gestational length.

Positron emission tomography (PET) with fluorine-18 (18F)-fluoro-2-deoxyglucose (FDG) has been proven to be a valuable noninvasive imaging modality for the diagnosis, staging, and monitoring of therapy for various malignancies. In addition, studies are demonstrating the value of FDG-PET for the evaluation of nononcologic conditions. Based on the literature, conditions such as osteomyelitis, fever of unknown origin (FUO), acquired immunodeficiency syndrome (AIDS), vasculitis, and inflammatory bowel disease can be successfully imaged with FDG-PET. With the approval of additional PET radiotracers in the future, there will be more widespread applications of PET for inflammatory and infectious disorders.

ObjectiveAmbient air pollution (micro-particles) is associated with poor pregnancy outcome. We hypothesized that maternal exposure to micro-particles activates the immune system in placenta and fetus. Our objective was to test this hypothesis by investigating the effect of intraperitoneal microparticle exposure of the mother on fetal and placental cyclooxygenase (Cox)-2 promoter activation.Study DesignThe Cox-2luc+ SKH1 mice express firefly luciferase reporter enzyme at the start site of translation for the Cox-2 gene. Stimulation of this animal with microbial antigens induces activation of Cox-2, which can be visualized and quantitated in vivo using a Xenogen camera. We developed a novel Cox2 luciferase mouse pregnancy model. Mating of wild-type-females with Cox-2luc+ males leads to heterozygous pups which can be visualized in utero. 100 microL of LPS-free 0.05 microm-microparticle (∼mass of ultrafine particles breathed by a mouse in 10 days of exposure to ambient air) was injected i.p. in 14 day (2nd trimester)pregnant mice carrying Cox-2luc+ heterozygous pups (n=6 mothers). A seperate cohort was injected with PBS as control. Microparticle and PBS induced luciferase activity was assessed via Xenogen camera (Caliper Life Sciences) at 0, 4 and 24hr after injection.ResultsMaternal microparticle injection induced 100% increase in luciferase activity in the pups/placentas (p<0.05) at 4 hr. Luciferase activity returned to baseline at 24hr. The mothers did not exhibit any sign of illness throughout the course of the experiment and systemic microparticle exposure did not affect pup growth at 24hr as assessed by luciferase activity.ConclusionIn utero microparticle exposure leads to transient inflammation (Cox2 activation) in the fetus/placenta. Repeated exposure to microparticles may lead to chronic inflammation.This may potentially effect placental and fetal development, and lead to poor pregnancy outcome. ObjectiveAmbient air pollution (micro-particles) is associated with poor pregnancy outcome. We hypothesized that maternal exposure to micro-particles activates the immune system in placenta and fetus. Our objective was to test this hypothesis by investigating the effect of intraperitoneal microparticle exposure of the mother on fetal and placental cyclooxygenase (Cox)-2 promoter activation. Ambient air pollution (micro-particles) is associated with poor pregnancy outcome. We hypothesized that maternal exposure to micro-particles activates the immune system in placenta and fetus. Our objective was to test this hypothesis by investigating the effect of intraperitoneal microparticle exposure of the mother on fetal and placental cyclooxygenase (Cox)-2 promoter activation. Study DesignThe Cox-2luc+ SKH1 mice express firefly luciferase reporter enzyme at the start site of translation for the Cox-2 gene. Stimulation of this animal with microbial antigens induces activation of Cox-2, which can be visualized and quantitated in vivo using a Xenogen camera. We developed a novel Cox2 luciferase mouse pregnancy model. Mating of wild-type-females with Cox-2luc+ males leads to heterozygous pups which can be visualized in utero. 100 microL of LPS-free 0.05 microm-microparticle (∼mass of ultrafine particles breathed by a mouse in 10 days of exposure to ambient air) was injected i.p. in 14 day (2nd trimester)pregnant mice carrying Cox-2luc+ heterozygous pups (n=6 mothers). A seperate cohort was injected with PBS as control. Microparticle and PBS induced luciferase activity was assessed via Xenogen camera (Caliper Life Sciences) at 0, 4 and 24hr after injection. The Cox-2luc+ SKH1 mice express firefly luciferase reporter enzyme at the start site of translation for the Cox-2 gene. Stimulation of this animal with microbial antigens induces activation of Cox-2, which can be visualized and quantitated in vivo using a Xenogen camera. We developed a novel Cox2 luciferase mouse pregnancy model. Mating of wild-type-females with Cox-2luc+ males leads to heterozygous pups which can be visualized in utero. 100 microL of LPS-free 0.05 microm-microparticle (∼mass of ultrafine particles breathed by a mouse in 10 days of exposure to ambient air) was injected i.p. in 14 day (2nd trimester)pregnant mice carrying Cox-2luc+ heterozygous pups (n=6 mothers). A seperate cohort was injected with PBS as control. Microparticle and PBS induced luciferase activity was assessed via Xenogen camera (Caliper Life Sciences) at 0, 4 and 24hr after injection. ResultsMaternal microparticle injection induced 100% increase in luciferase activity in the pups/placentas (p<0.05) at 4 hr. Luciferase activity returned to baseline at 24hr. The mothers did not exhibit any sign of illness throughout the course of the experiment and systemic microparticle exposure did not affect pup growth at 24hr as assessed by luciferase activity. Maternal microparticle injection induced 100% increase in luciferase activity in the pups/placentas (p<0.05) at 4 hr. Luciferase activity returned to baseline at 24hr. The mothers did not exhibit any sign of illness throughout the course of the experiment and systemic microparticle exposure did not affect pup growth at 24hr as assessed by luciferase activity. ConclusionIn utero microparticle exposure leads to transient inflammation (Cox2 activation) in the fetus/placenta. Repeated exposure to microparticles may lead to chronic inflammation.This may potentially effect placental and fetal development, and lead to poor pregnancy outcome. In utero microparticle exposure leads to transient inflammation (Cox2 activation) in the fetus/placenta. Repeated exposure to microparticles may lead to chronic inflammation.This may potentially effect placental and fetal development, and lead to poor pregnancy outcome.

OBJECTIVE:To evaluate a sample of locally available corn-based foods for fumonisin contamination.STUDY DESIGN:We analyzed 38 corn tortilla and masa flour samples from Los Angeles, San Diego and Tijuana, Mexico,for fumonisin contamination. Retail sources were diverse and not limited to Hispanic neighborhoods.RESULTS:Fumonisins were found in all samples. The median fumonisin B1 mycotoxin level was 84 ng/g, with a range of 1-729 (n = 38). The median total fumonisin level was 231 ng/g, with a range of 2.8-1,863. Levels of fumonisins differed by geographic site.CONCLUSION:Fumonisin contamination of corn-based foods in southern California is common. At levels of contamination > 1,000 ng/g, a 60-kg potentially pregnant woman could exceed the World Health Organization recommendations by eating 120 g (dry weight) of corn products daily. Fumonisin contamination may constitute a preventable risk for NTDs among susceptible reproductive-age women and their progeny.