Asunto(s)
Simulación por Computador , Granuloma de Células Gigantes/cirugía , Enfermedades Mandibulares/cirugía , Cirugía Asistida por Computador , Granuloma de Células Gigantes/diagnóstico por imagen , Humanos , Imagenología Tridimensional , Enfermedades Mandibulares/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND AND PURPOSE: Anxiety and depression during pregnancy have been associated with an increased risk of adverse neurodevelopmental outcomes in offspring. We aimed to study the in utero effects of maternal anxiety and depression on early brain development. MATERIALS AND METHODS: Pregnant women were recruited at â¼36 weeks of gestation for this prospective study. They were assessed for anxiety symptoms by the State-Trait Anxiety Inventory and for depression symptoms by the Beck Depression Inventory, 2nd Edition. After delivery, infant underwent an MR imaging examination of the brain without sedation, including DTI, for evaluation of white matter (WM) development. Infant fractional anisotropy values, a putative marker of WM integrity, were correlated with the mothers' State-Trait Anxiety Inventory and Beck Depression Inventory scores by using both tract-based spatial statistics and ROI methods. RESULTS: Thirty-four infants were included in this study. Both maternal State-Anxiety and Trait-Anxiety scores negatively correlated (P < .05, corrected) with fractional anisotropy values in widespread brain WM regions; Beck Depression Inventory scores also negatively correlated (P < .05) with fractional anisotropy values in one cluster in the brain. Further ROI analyses confirmed significant negative correlations between average fractional anisotropy values in ROIs including left and right prefrontal WM, left and right middle frontal gyrus WM, and the fornix, and State-Anxiety (R values, -0.47 to -0.67; P values, .008 to <.001), Trait-Anxiety (R, -0.37 to -0.59; P, .04 to <.001), and Beck Depression Inventory (R values, -0.36 to -0.55; P, .05 to .002) scores. CONCLUSIONS: Higher maternal anxiety and depression symptom scores during late pregnancy were associated with lower estimated infant brain WM development, which indicated in utero influences of maternal mental health during pregnancy on the developing brain.
Asunto(s)
Ansiedad , Encéfalo/crecimiento & desarrollo , Depresión , Madres/psicología , Efectos Tardíos de la Exposición Prenatal , Sustancia Blanca/crecimiento & desarrollo , Adulto , Desarrollo Infantil , Imagen de Difusión Tensora/métodos , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Estudios ProspectivosAsunto(s)
Arteritis de Células Gigantes , Arterias Temporales , Biopsia , Humanos , Herida QuirúrgicaRESUMEN
The main complications of a biopsy of the superficial temporal artery using a standard preauricular approach include scars on the face, weakness of the temporal branch of the facial nerve, and the possible harvest of a disease-free segment of artery. We describe a modification of the Gillies temporal approach, which when placed at the junction of the frontal and parietal branch can be easily modified to harvest either branch. It avoids scarring to the face as it is hidden within the hairline. The incision placed with specific measurements and palpation is easily reproducible. In patients with giant cell arteritis, arterial wall thickening, and narrowing of the lumen, reduced blood flow makes it harder to identify the artery with a Doppler scan. A procedure based on measurements and palpation is therefore likely to yield better results.
Asunto(s)
Arteritis de Células Gigantes/patología , Arterias Temporales/patología , Biopsia/métodos , Humanos , PalpaciónRESUMEN
Neisseria meningitidis serogroups B and C have been responsible for the majority of invasive meningococcal disease in Australia, with serogroup B strains causing an increasing proportion of cases in recent years. Serogroup Y has typically caused sporadic disease in Australia. In 2002, a cluster of 4 cases was reported from a rural region in Queensland. Three of these cases were serogroup C, with 1 case diagnosed by molecular detection only, and the fourth case was identified as a serogroup Y infection. Genomic analysis, including antigen finetyping, multilocus sequence typing (MLST), and core genome MLST, demonstrated that the serogroup Y case, though spatially and temporally linked to a serogroup C disease cluster, was not the product of a capsule switch and that one of the serogroup C isolates had a deletion of the entire porA sequence.
Asunto(s)
Brotes de Enfermedades , Infecciones Meningocócicas/microbiología , Neisseria meningitidis/genética , Porinas/genética , Análisis por Conglomerados , Humanos , Infecciones Meningocócicas/epidemiología , Tipificación de Secuencias Multilocus , Neisseria meningitidis/inmunología , Neisseria meningitidis/aislamiento & purificación , Queensland , Análisis de Secuencia de ADN , SerogrupoRESUMEN
Haemophilus influenzae is an important aetiological organism of both adult and child respiratory disease. The number of non-typeable (NTHi) invasive H. influenzae isolates referred to the Queensland (QLD) Public Health Microbiology laboratory has increased notably year-by-year. In this study we used whole-genome sequencing to molecularly characterise 100 referred invasive H. influenzae, including 74 NTHi isolates over a 15-year period, observing the carriage of capsular and putative virulence genes, including the major adhesins, antimicrobial resistance genes and population diversity. Encapsulated isolates were largely clonal, however NTHi isolates displayed high genetic variability by MLST and single nucleotide polymorphism typing with no dominant clone observed. The only mechanism for ß-lactam resistance identified in the QLD isolates was ß-lactamase production. No single set of virulence determinants was conclusively associated with invasive QLD NTHi isolates.
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Genes Bacterianos/genética , Infecciones por Haemophilus/microbiología , Haemophilus influenzae/genética , Haemophilus influenzae/patogenicidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Infecciones por Haemophilus/epidemiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Tipificación de Secuencias Multilocus , Prevalencia , Queensland/epidemiología , Análisis de Secuencia de ADN , Virulencia , Adulto JovenAsunto(s)
Anestesia Dental/normas , Anestesia Local/normas , Embarazo/efectos de los fármacos , Anestesia Dental/efectos adversos , Anestesia Local/efectos adversos , Bupivacaína , Epinefrina/efectos adversos , Femenino , Humanos , Lidocaína/administración & dosificación , Lidocaína/efectos adversos , PrilocaínaRESUMEN
OBJECTIVES: Streptococcus pneumoniae isolates from Australian invasive pneumococcal disease cases displaying an atypical 35B phenotype. Whole genome sequencing was used to analyse these strains and identify changes to the capsule gene regions. METHODS: Four atypical serogroup 35 isolates from Australian reference laboratories were unable to be assigned to one of the four known group 35 serotypes by the Quellung serotyping method. Genetic characterization of the capsule locus was performed by bioinformatic analysis of whole genome sequencing data for all isolates. RESULTS: Genetic analysis identified four independent disruptions to the wciG gene, which encodes an O-acetyltransferase responsible for the O-acetylation of the 6Galß1 residue in the capsular polysaccharide repeat unit of serotype 35B. CONCLUSIONS: This is the first published report on the incidence and capsular gene characteristics of a S. pneumoniae 35B variant.
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Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Serogrupo , Serotipificación , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Genotipo , Técnicas de Genotipaje , Humanos , Incidencia , Lactante , Persona de Mediana Edad , Streptococcus pneumoniae/genética , Secuenciación Completa del GenomaRESUMEN
OBJECTIVES: To investigate the potential for next generation sequencing (NGS) to be used directly on clinical specimens that have tested positive for Neisseria gonorrhoeae by nucleic acid amplification testing (NAAT), to generate information on epidemiological genotyping and antimicrobial resistance (AMR) markers. METHODS: DNA was extracted from 13 N. gonorrhoeae NAAT-positive urine specimens, enriched for microbial DNA and sequenced using the Ion Torrent PGM workflow. Sequences that aligned to the human genome were filtered out and the remaining sequences were de novo assembled. The resulting contigs were searched for regions of interest using Ridom SeqSphere. MLST and NG-MAST alleles were assigned according to the schemes at PubMLST.org and NG-MAST.net, respectively. RESULTS: In total, 11 of the 13 samples tested generated a sufficient number of N. gonorrhoeae sequence reads to provide full coverage of the genome at a depth of 6-130×. Complete MLST and NG-MAST sequence types could be generated for each of these samples. The presence of 10 different AMR markers was investigated, and both previously reported and novel mutations were identified in genes associated with reduced susceptibility to several antimicrobials. CONCLUSIONS: We found that sequencing the entire genome of N. gonorrhoeae directly from clinical samples is possible using NGS, and that multiple levels of N. gonorrhoeae typing information can be generated. As NAAT only testing becomes more common, this method could be used to detect both known and novel mutations associated with AMR and to generate genotyping information, supporting AMR and epidemiological surveillance in the absence of culturing.
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Antibacterianos/farmacología , Farmacorresistencia Bacteriana/efectos de los fármacos , Gonorrea/epidemiología , Gonorrea/orina , Secuenciación de Nucleótidos de Alto Rendimiento , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Farmacorresistencia Bacteriana/genética , Genes Bacterianos/genética , Marcadores Genéticos/genética , Gonorrea/microbiología , Humanos , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Neisseria gonorrhoeae/efectos de los fármacos , Técnicas de Amplificación de Ácido NucleicoRESUMEN
We describe the management of a pathological fracture in a patient with medication-related osteonecrosis using a cast-cap splint. In selected cases this is a simple solution to what can be a difficult condition to treat.