Enzyme activities of plasma and selected tissues in rainbow trout Salmo gairdneri Richardson

This paper describes the determination in rainbow trout of the normal levels in the plasma of eight enzymes known to be significant in animal pathology. Some relationships between plasma enzyme levels and the enzyme activities in selected tissues are discussed. For LDH which is ubiquitously distributed, we chose, by way of saturation tests, the optimum concentrations of pyruvate and NADH in the assay medium. The LDH 'isoenzyme ratio' was determined for heart tissue, liver, and white muscle. When blood was withdrawn from caudal vessels, we observed a net increase of plasma enzyme activities, mainly of CPK and LDH, which was demonstrated to originate from surrounding muscle. Thus cardiac sampling was the only suitable way of obtaining blood for this kind of study. Slightly haemolyzed blood appeared suitable for enzyme determinations except for Alk Pase which is about 50 times more concentrated in erythrocytes than in plasma. CPK was highly concentrated in the heart and the muscle, GOT was concentrated in the heart while the liver appeared to be a valuable source of GDH (as well as the kidney) and GPT.     

Interactions between Carbon and Nitrogen Metabolism in Fibrobacter succinogenes S85: a 1H and 13C Nuclear Magnetic Resonance and Enzymatic Study

The effect of the presence of ammonia on [1-¹³C]glucose metabolism in the rumen fibrolytic bacterium Fibrobacter succinogenes S85 was studied by ¹³C and ¹H nuclear magnetic resonance (NMR). Ammonia halved the level of glycogen storage and increased the rate of glucose conversion into acetate and succinate 2.2-fold and 1.4-fold, respectively, reducing the succinate-to-acetate ratio. The ¹³C enrichment of succinate and acetate was precisely quantified by ¹³C-filtered spin-echo difference ¹H-NMR spectroscopy. The presence of ammonia did not modify the ¹³C enrichment of succinate C-2 (without ammonia, 20.8%, and with ammonia, 21.6%), indicating that the isotopic dilution of metabolites due to utilization of endogenous glycogen was not affected. In contrast, the presence of ammonia markedly decreased the ¹³C enrichment of acetate C-2 (from 40 to 31%), reflecting enhanced reversal of the succinate synthesis pathway. The reversal of glycolysis was unaffected by the presence of ammonia as shown by ¹³C-NMR analysis. Study of cell extracts showed that the main pathways of ammonia assimilation in F. succinogenes were glutamate dehydrogenase and alanine dehydrogenase. Glutamine synthetase activity was not detected. Glutamate dehydrogenase was active with both NAD and NADP as cofactors and was not repressed under ammonia limitation in the culture. Glutamate-pyruvate and glutamate-oxaloacetate transaminase activities were evidenced by spectrophotometry and ¹H NMR. When cells were incubated in vivo with [1-¹³C]glucose, only ¹³C-labeled aspartate, glutamate, alanine, and valine were detected. Their labelings were consistent with the proposed amino acid synthesis pathway and with the reversal of the succinate synthesis pathway.     

Birth outcomes following cesarean delivery on maternal request: a population-based cohort study

BACKGROUND:Data on the effect of cesarean delivery on maternal request (CDMR) on maternal and neonatal outcomes are inconsistent and often limited by inadequate case definitions and other methodological issues. Our objective was to evaluate the trends, determinants and outcomes of CDMR using an intent-to-treat approach.METHODS:We designed a population-based retrospective cohort study using data on low-risk pregnancies in Ontario, Canada (April 2012–March 2018). We assessed temporal trends and determinants of CDMR. We estimated the relative risks for component and composite outcomes used in the Adverse Outcome Index (AOI) related to planned CDMR compared with planned vaginal delivery using generalized estimating equation models. We compared the Weighted Adverse Outcome Score (WAOS) and the Severity Index (SI) across planned modes of delivery using analysis of variance.RESULTS:Of 422 210 women, 0.4% (n = 1827) had a planned CDMR and 99.6% (n = 420 383) had a planned vaginal delivery. The prevalence of CDMR remained stable over time at 3.9% of all cesarean deliveries. Factors associated with CDMR included late maternal age, higher education, conception via in vitro fertilization, anxiety, nulliparity, being White, delivery at a hospital providing higher levels of maternal care and obstetrician-based antenatal care. Women who planned CDMR had a lower risk of adverse outcomes than women who planned vaginal delivery (adjusted relative risk 0.42, 95% confidence interval [CI] 0.33 to 0.53). The WAOS was lower for planned CDMR than planned vaginal delivery (mean difference −1.28, 95% CI −2.02 to −0.55). The SI was not statistically different between groups (mean difference 3.6, 95% CI −7.4 to 14.5).Interpretation:Rates of CDMR have not increased in Ontario. Planned CDMR is associated with a decreased risk of short-term adverse outcomes compared with planned vaginal delivery. Investigation into the long-term implications of CDMR is warranted.

Cesarean delivery is the most common inpatient surgical procedure in North America,^1,2 where rates often exceed World Health Organization recommendations (10%–15% of deliveries).³ Given the financial and resource implications of cesarean deliveries on health care systems, the contribution of cesarean deliveries on maternal request (CDMR) to rising cesarean section rates is of ongoing interest. Women may prefer CDMR for many reasons, including scheduling convenience, anxiety regarding labour pain, perceptions that the quality of obstetrical care is better for women who have cesarean deliveries, and concerns about possible urinary incontinence and sexual dysfunction after vaginal delivery.^4–7 Challenges in characterizing the epidemiology of CDMR include the lack of internationally accepted case definitions and inconsistencies in documentation that hinder meaningful comparisons across jurisdictions.^8–11 In Canada, the prevalence of CDMR has been estimated at 2% of cesarean deliveries,¹² but robust contemporary data are lacking.The benefits of vaginal delivery are well known and include a lower risk of transient tachypnea of the newborn, newborn exposure to the vaginal microbiome, shorter maternal hospital stays and lower risk of complications associated with abdominal surgeries. The findings of 1 Canadian study suggest that midpelvic operative vaginal delivery is associated with a greater risk of severe birth and obstetric trauma than cesarean delivery.¹³ Evidence on the risks and benefits of CDMR is sparse, and existing data are inconsistent.^14–19 Analyses are frequently limited by inadequate case definitions and unaddressed confounding from baseline maternal and neonatal factors.^4,11 Professional organizations in the United States, Canada and Europe do not recommend CDMR over vaginal delivery.^11,20–22 Patient counselling is suggested to inform patients of pain management options, and of potential benefits and harms related to cesarean deliveries. However, obstetrical care providers often accede to patient preferences, given the ethical imperative of patient autonomy. ^23–27 Contemporary, high-quality observational studies leveraging robust population-based data are required. Our objective was to evaluate the trends, determinants and outcomes of CDMR compared with planned vaginal delivery using an intent-to-treat approach.