ObjectiveTo evaluate the safety of rituximab treatment before and during pregnancy in women with MS and neuromyelitis optica spectrum disorders (NMOSDs) who may be at risk of relapses by performing a systematic literature review combined with a retrospective single-center case series.MethodsStudies were systematically identified in the PubMed, Google Scholar, and EMBASE using the key terms “pregnancy” and “rituximab”; 22 articles were included for review (>17,000 screened). Then, patients with MS and NMOSD from 1 center (University of California, San Francisco) exposed to rituximab before conception were identified through medical record review.ResultsSystematic review: We identified 102 pregnancies with rituximab use within 6 months of conception: 78 resulted in live births and 12 in spontaneous abortions. Of 54 live births with reported gestational age, 31 occurred at term (37 weeks+) and 2 before 32 weeks. When checked, B-cell counts were low in 39% of newborns and normalized within 6 months. Case series: we identified 11 pregnancies (1 ongoing) in 10 women (7 MS and 3 NMOSD) treated with rituximab within 6 months of conception. All completed pregnancies resulted in term live births of healthy newborns (1 lost to follow-up at term). No maternal relapses occurred before/during pregnancy; 1 occurred postpartum (NMOSD).ConclusionNo major safety signal was observed with rituximab use within 6 months of conception. Beyond the need for monitoring neonatal B cells, these observations support prospectively monitoring a larger patient cohort to determine whether rituximab may safely protect women with MS and NMOSD who are planning a pregnancy against relapses.

One of the best neurohistologic methods to reveal the cytoarchitecture of the brain and detailed morphology of neurons with unsurpassed clarity has been the Golgi staining. It is based on the principle of metallic impregnation of neurons, allowing visualization in their entirety including cell soma, axons, dendrites, and spines. In this chapter, we describe the Golgi-Cox protocol standardized in our laboratory that can be used to study experimental effects of different genetic manipulations on spatial distribution of neurons, dendrite density, spine number and morphology to elucidate gene functions during development and in adult brain.

BackgroundDue to the growing availability of consumer information, the protection of personal data is of increasing concern.ObjectiveWe assessed readability metrics of privacy policies for apps that are either available to or targeted toward youth to inform strategies to educate and protect youth from unintentional sharing of personal data.MethodsWe reviewed the 1200 highest ranked apps from the Apple and Google Play Stores and systematically selected apps geared toward youth. After applying exclusion criteria, 99 highly ranked apps geared toward minors remained, 64 of which had a privacy policy. We obtained and analyzed these privacy policies using reading grade level (RGL) as a metric. Policies were further compared as a function of app category (free vs paid; entertainment vs social networking vs utility).ResultsAnalysis of privacy policies for these 64 apps revealed an average RGL of 12.78, which is well above the average reading level (8.0) of adults in the United States. There was also a small but statistically significant difference in word count as a function of app category (entertainment: 2546 words, social networking: 3493 words, and utility: 1038 words; P=.02).ConclusionsAlthough users must agree to privacy policies to access digital tools and products, readability analyses suggest that these agreements are not comprehensible to most adults, let alone youth. We propose that stakeholders, including pediatricians and other health care professionals, play a role in educating youth and their guardians about the use of Web-based services and potential privacy risks, including the unintentional sharing of personal data.

IntrOductIOnSpinal anaesthesia is the gold standard for lower abdominal surgeries. It has got the advantage of being, cost-effective, easy administration technique, rapid onset of action, with relatively less adverse effects and most importantly patient remaining aroused throughout the procedure [1]. But at times short duration and uncomfortable postoperative period offset the above advantages. Therefore, in order to extend the intraoperative analgesia into postoperative period, following spinal anaesthesia, various spinal adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice. Such adjuvants have been helpful in induction of early ambulation along with prolongation of analgesia but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on.Alpha-2 (α 2 ) adrenergic receptor agonists have been tried by many clinicians due to their sedative, anxiolytic, hypnotic, analgesic, perioperative sympatholytic and stable haemodynamic properties [2]. The initiation for the use of α 2 agonists in anaesthesia resulted from observations made in patients who were receiving clonidine therapy. Dexmedetomidine, a Dextro (s) isomer of medetomidine was approved for short term sedation in 1999. It possesses all the above properties but lacks respiratory depressant action; making it a relatively safe agent [3]. Currently its adjuvant action in spinal anaesthesia is being explored. Various adjuvants like morphine, buprenorphine and fentanyl, clonidine, ketamine are being used in anaesthetic practice since long for improvement of peri-operative analgesia following spinal anaesthesia. Such adjuvants have been helpful in induction of early ambulation but at the cost of their associated adverse effects. Therefore search for an effective adjuvant is still going on. Currently Dexmedetomidine, a highly selective α 2 -adrenoreceptor agonist is being studied for its adjuvant action in spinal anaesthesia.

BackgroundThe Eph family of receptor tyrosine kinases plays important roles in neural development. Previous studies have implicated Eph receptors and their ligands, the ephrins, in neuronal migration, axon bundling and guidance to specific targets, dendritic spine formation and neural plasticity. However, specific contributions of EphA5 and EphA6 receptors to the regulation of neuronal cell morphology have not been well studied.ResultsHere we show that deletion of EphA5 and EphA6 results in abnormal Golgi staining patterns of cells in the brain, and abnormal spine morphology.ConclusionThese observations suggest novel functions of these Eph receptors in the regulation of neuronal and spine structure in brain development and function.