Brief Report: Sensory Reactivity in Children with Phelan-McDermid Syndrome.

Phelan-McDermid syndrome (PMS), a monogenic form of autism spectrum disorder (ASD), results from deletion or mutation of the SHANK3 gene. Atypical sensory reactivity is now included in the diagnostic criteria for ASD. Examining the sensory phenotype in monogenic forms of ASD, such as PMS, may help identify underlying mechanisms of sensory reactivity. Using the Short Sensory Profile, the current study compared sensory reactivity in 24 children with PMS to 61 children with idiopathic ASD (iASD). Results suggest that children with PMS show more low energy/weak symptoms and less sensory sensitivity as compared to children with iASD. This study is the first to demonstrate differences in sensory reactivity between children with PMS and iASD, helping to refine the PMS phenotype.

Risk factors for rape re-victimisation: a retrospective analysis.

Sexual re-victimisation refers to a pattern in which the sexual assault victim has an increased risk of subsequent victimisation relative to an individual who was never victimised. The purpose of our study was to identify risks factors for a second rape, the severest form of sexual re-victimisation. All rape victims treated at the First Regional Israeli Center for Sexual Assault Victims between October 2000 and July 2010 were included in this retrospective analysis. We compared characteristics of 53 rape victims who were victimised twice to those of 1,939 rape victims who were victimised once. We identified several risk factors for a second rape, which can be used in prevention programmes. These are: psychiatric background, history of social services involvement, adulthood, non-virginity and minority ethnicity.

Fasting does not precipitate onset of labour.

This retrospective observational study examined whether fasting (the 'Yom Kippur effect') precipitates labour. Birth rates of Yom Kippur (a fasting festival) were compared with those of other festivals that are observed (Tisha B'Av) and not observed (1st day of Passover) by fasting during a 4-year period. Compared with the mean birth rate, the number of births that occurred 1 day after Yom Kippur was increased (p = 0.023). A significant decrease in the number of births during Tisha B'Av (p = 0.044) and a significant increase in the number of births 2 days after Tisha B'Av (p = 0.009) was observed. Two days prior to the 1st day of Passover, a significant decrease in the number of births was also observed (p = 0.034). Contrary to previous reports, the present study does not confirm an association between a 1-day long fast and increased birth rate in the 24-h period after breaking of the fast.

Vacuum extraction and herpes simplex virus infection.

OBJECTIVE: To search for an association between delivery by vacuum extraction and an increased neonatal risk for herpes simplex virus (HSV) infection. METHODS: In a cross-sectional, descriptive, controlled study, the study (vacuum extraction) and control (spontaneous delivery) groups each included 50 consecutive women with no history of HSV infection. Cultures for HSV were obtained from the genital tracts of all parturient women and the scalps of their newborns. RESULTS: Following operative vaginal delivery, two newborns (4%) had scalp vesicles and cultures were positive for HSV for both mothers and newborns; two newborns (4%) had scalp vesicles and cultures were negative for HSV; and two newborns (4%) without scalp vesicles had cultures positive for HSV. Following spontaneous delivery, cultures were positive for HSV for four women and their newborns (8%). CONCLUSION: Herpes simplex virus isolated from the scalps of newborns may often result from colonization rather than infection.

Thermal death kinetics of egg and third instar Mediterranean fruit fly (Diptera: Tephritidae).

Two developmental stages of Ceratitis capitata (Wiedemann), 24-h-old eggs and third instars, 8 d after oviposition, were subjected to thermal exposures in a heating block system, at various temperatures of 46, 48, 50, and 52 degrees C to determine the thermal death kinetics of the insects. At these temperatures, 100% mortality was achieved by exposure of 300 C. capitata larvae for 60, 15, 4, and 1 min, respectively. The 0.5 order kinetic model had the best fit to the survival ratio for all the treatment temperatures, hence it was used for the prediction of the lethal times. The thermal death time (TDT) curves showed that the third instars were more heat-resistant than eggs, especially at the two low temperatures (46 and 48 degrees C). Under temperature-time combinations that did not result in complete kill, the thermal mortality for eggs was also significantly higher than that for third instars. The activation energy values calculated from the TDT curves were 490.6 and 551.9 kJ/mol, respectively, for thermal death of eggs and third instars.

Relationship between uterine contractions and serum magnesium levels in patients treated for threatened preterm labour with intravenous magnesium sulphate.

We aimed to correlate the assessment of preterm uterine activity with serum magnesium levels in women with threatened preterm labour. The observational study involved twelve women receiving intravenous magnesium sulphate for threatened preterm labour. Mean gestational age at initiation of therapy was 26.9+/-2.9 weeks. Mean cervical dilatation at initiation of therapy was 1.5 cm. Serum magnesium levels and evaluation of uterine contractions by external tocograph were assessed twice daily. Presence or absence of contractions was analysed for correlation with plasma magnesium levels. Eighty-eight measurements were analysed. The mean serum magnesium levels were 1.9+/-0.5 mmol/l and 1.9+/-0.3 mmol/l in the presence (n=22) or absence (n=66) of contractions, respectively. The difference did not reach statistical significance. No correlation was found between serum magnesium levels and presence of contractions (P=0.3, logistic regression odds ratio 1.1, 95% confidence interval of 0.6-2.0). The abolition of premature uterine contractions during intravenous magnesium sulphate therapy does not correlate with serum magnesium levels.

Caesarean delivery during maternal cardiopulmonary resuscitation for status asthmaticus.

A patient who sustained a recurrent cardiopulmonary resuscitation due to status asthmaticus during one pregnancy followed by a birth of an apparently normal infant is described. Promptly performed caesarean delivery might have saved the mother and her infant. Cardiopulmonary resuscitation is less effective in a near term pregnant woman.

Is antibody screening in Rh (D)-positive pregnant women necessary?

OBJECTIVE: Hemolytic disease of the fetus and of the newborn can be caused by incompatibility of maternal and fetal erythrocytes for Rh (D) or other blood type antigens. Routine antibody screening is advocated in all pregnant women, irrespective of whether they are Rh (D)-positive or Rh (D)-negative, to look for clinically significant alloantibodies other than Rh (D) that might cause hemolytic disease of the newborn. The purpose of this study was to assess the incidence of blood type antibodies other than Rh (D) in pregnant women attending for prenatal care in a typical urban population. METHODS: A retrospective analysis was undertaken of the charts of all pregnant women followed throughout their entire pregnancy at our Women's Health Center from 1 January 1999 to 30 April 2002. RESULTS: There were 1265 pregnant women included in the study: 465 had blood type A (36.7%), 269 type B (21.3%), 424 type O (33.5%) and 107 type AB (8.5%). A total of 1156 were Rh (D)-positive (91.4%) and 109 were Rh (D)-negative (8.6%). Of the Rh (D)-positive women, 522 (41.3%) underwent routine antibody screening in the first trimester. Only one woman (0.2%) had a positive antibody screen. Of the 109 Rh (D)-negative women, one (0.9%) had a positive third trimester screen with a negative first trimester screen. CONCLUSION: Routine antibody screening of Rh (D)-positive women is probably not warranted from a clinical cost-benefit perspective.

Symptomatic hyponatremia following cesarean section.

A rare occurrence of the syndrome of inappropriate antidiuretic hormone secretion is described in a 32-year-old previously healthy nulliparous woman who underwent a Cesarean section for non-progressive labor.

Assessment of a newer technique for cesarean section.

We present a new method for cesarean section that predominantly employs blunt techniques. We used it in 51 patients having a first cesarean section and compared the results with 51 matched controls having a standard technique first cesarean section.

Adnexal torsion with a paraovarian cyst in a teenage girl.

Adnexal torsion with a paraovarian cyst in adolescent or premenarchal girls is extremely rare and very difficult to diagnose before surgery. We identified three published cases of the disorder in adolescent or premenarchal girls. Our patient, a 12.5-year-old girl, is the fourth. The cyst was excised and the adnexa untwisted at laparoscopy. High awareness and timely laparoscopy contributed to conservation of the adnexa in our young patient.

Value of vaginal culture in management of acute vaginitis.

OBJECTIVE: To evaluate the relative contribution of clinical assessment and vaginal discharge cultures in the treatment of acute vaginitis. METHODS: A prospective observational study of 75 consecutive sexually active women with acute vaginal symptoms was undertaken. Each patient underwent an evaluation that included a standardized history, interview a thorough pelvic examination and vaginal culture. The treatment was administered based upon patient symptomatology and macroscopic appearance of vaginal discharge. RESULTS: There was an agreement between initial diagnosis and culture isolates in 38 patients (50.6%). Of the 75 enrolled women 9 have not returned for reevaluation 8 days after initiation of the treatment. Fifty three (80.3%) of the remaining 66 women were free of symptoms 8 days after initiation of the treatment. The remaining 13 women were treated successfully in accordance with the vaginal culture result. CONCLUSION: A high cure rate of acute vaginitis could be achieved based upon physical examination. Vaginal cultures are valuable in initial therapy failures.