RESUMO
Discontinuing routine processing of screening urine cultures prior to elective joint arthroplasty resulted in substantial reduction in urine cultures ordered and antimicrobial prescriptions for asymptomatic bacteriuria, without any significant impact on incidence of prosthetic joint infection. This simple change would be scalable across institutions with potential for significant healthcare savings.
Assuntos
Artroplastia de Substituição , Procedimentos Cirúrgicos Eletivos , Infecção da Ferida Cirúrgica/etiologia , Urinálise , Infecções Urinárias/complicações , Infecções Urinárias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Substituição/efeitos adversos , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Medição de Risco , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
The A-class of the erythropoietin-producing hepatocellular carcinoma cell-derived (EphA) tyrosine kinase receptors and their ligands, the A-ephrins, play critical roles in the specification of topographic axon projection maps during development. In this study, the role of the EphA subfamily in callosal projections was investigated using transgenic mice expressing a kinase deletion mutant of EphA5. In approximately half of these transgenic mice, cerebral cortical neurons in various cortical regions (primary and secondary somatosensory cortices and frontal as well as visual areas) failed to project to the contralateral cortex. When commissural axons were examined with DiI labeling, few callosal fibers were found to traverse the midline in both the adult and neonatal transgenic mice. This defect in callosal development correlates with the expression of the transgene, because neurons in the superficial layers of the motor cortex, where transgene expression is low, show normal contralateral projection through the corpus callosum. In addition, multiple EphA receptors are expressed in callosal neurons and ephrin-A5 stimulates neurite outgrowth of callosal neurons in vitro. The midline glia structures important for callosal axon midline crossing appear normal in the transgenic mice, suggesting that the defects are unrelated to defective guidance structures at the midline. These observations suggest critical functions for EphA receptor in establishing callosal connections during brain development.
Assuntos
Agenesia do Corpo Caloso , Malformações do Sistema Nervoso/genética , Receptores da Família Eph/biossíntese , Receptores da Família Eph/genética , Animais , Axônios/patologia , Córtex Cerebral/patologia , Corpo Caloso/patologia , Expressão Gênica , Hibridização In Situ , Camundongos , Camundongos Endogâmicos , Camundongos Transgênicos , Malformações do Sistema Nervoso/patologia , Neuritos/patologia , Neurônios/patologia , RNA Mensageiro/metabolismo , TransgenesRESUMO
Topographic mapping of axon terminals is a general principle of neural architecture that underlies the interconnections among many neural structures. The Eph family tyrosine kinase receptors and their ligands, the ephrins, have been implicated in the formation of topographic projection maps. We show that multiple Eph receptors and ligands are expressed in the hippocampus and its major subcortical projection target, the lateral septum, and that expression of a truncated Eph receptor in the mouse brain results in a pronounced alteration of the hippocamposeptal topographic map. Our observations provide strong support for a critical role of Eph family guidance factors in regulating ontogeny of hippocampal projections.