Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study.

OBJECTIVE: To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN: Retrospective observational study. SETTING: Grenada. POPULATION: Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS: This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES: Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS: Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (µ = 898 days, σ = 277 days) compared with infections outside of pregnancy (µ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION: CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT: Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.

Gender-based violence: don’t ask, don’t tell, don’t care

OBJECTIVE: Our goal was to highlight the ongoing disparity, promote discussion, and advocate for further funding to examine the factors associated with sexual violence to target prevention rather than intervention. DESIGN AND METHODS: We compared prevalence, incidence, and economic burden of sexual violence to other major public health issues in the US: cardiovascular disease, cancer, and diabetes. We compared the public funding allocated to an issue as a proxy of the social priority of addressing the issue. Finally, we calculated the ratio of public funding to economic disease burden. RESULTS: [Table]. CONCLUSION: Public funds allocated to sexual violence were a fraction of those allocated to other major public health issues such as cardiovascular disease, cancer, and diabetes despite similar incidence, prevalence, and economic burden between them. While sexual violence was similarly prevalent and costly to these other major public health issues, it received a fraction of public funds.

[Technic and indications for cytodiagnosis for the early detection of cancer]. / Technik und Indikation der Zytodiagnostik für die Früherkennung des Karzinoms.

It is possible to detach cells from the surface of mucous membranes for cytodiagnostic purposes. The method is simple and does not involve discomfort to the patient. It can be repeated at any time and many times. The method should be used when observing changes in the mucous membranes during examination in order to detect precancerous formations and for tumor diagnosis.

Increase in cerebral perfusion pressure by arterial hypertension in brain swelling. A mathematical model of the volume-pressure relationship.

Brain swelling was produced in monkeys and cats by the inflation af an epidural balloon against the parietal lobe. Resulting changes in intracranial pressure (ICP) were correlated to variation in systemic arterial pressure (SAP). Intracranial perfusion pressure (ICPP) defined as the difference between SAP and ICP, was found to vary with the degree of arterial hyper-and hypotension. The relationship between SAP and ICP can be explained by an existing equilibrium between extramural pressure and vessel wall circumferential tension. A positive perfusion pressure can exist in brain swelling as long as vessel wall tension is preserved and the degree of expanding brain tissue volume is held below certain limits.