Ectopic Pregnancy in the Cervix: A Case Report

Cervical pregnancy is an extremely rare condition with potential grave consequences if not diagnosed and treated early enough. We present a case and an ultrasound image of early cervical ectopic pregnancy with a history of two previous cesarean sections who was successfully treated with suction curettage

Comparative genomics profiling of clinical isolates of Aeromonas salmonicida using DNA microarrays

BACKGROUND: Aeromonas salmonicida has been isolated from numerous fish species and shows wide variation in virulence and pathogenicity. As part of a larger research program to identify virulence genes and candidates for vaccine development, a DNA microarray was constructed using a subset of 2024 genes from the draft genome sequence of A. salmonicida subsp. salmonicida strain A449. The microarray included genes encoding known virulence-associated factors in A. salmonicida and homologs of virulence genes of other pathogens. We used microarray-based comparative genomic hybridizations (M-CGH) to compare selected A. salmonicida sub-species and other Aeromonas species from different hosts and geographic locations. RESULTS: Results showed variable carriage of virulence-associated genes and generally increased variation in gene content across sub-species and species boundaries. The greatest variation was observed among genes associated with plasmids and transposons. There was little correlation between geographic region and degree of variation for all isolates tested. CONCLUSION: We have used the M-CGH technique to identify subsets of conserved genes from amongst this set of A. salmonicida virulence genes for further investigation as potential vaccine candidates. Unlike other bacterial characterization methods that use a small number of gene or DNA-based functions, M-CGH examines thousands of genes and/or whole genomes and thus is a more comprehensive analytical tool for veterinary or even human health research

Time-dependent changes in mortality and transformation risk in MDS

In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making

RAS-pathway mutation patterns define epigenetic subclasses in juvenile myelomonocytic leukemia

Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative disorder of early childhood characterized by mutations activating RAS signaling. Established clinical and genetic markers fail to fully recapitulate the clinical and biological heterogeneity of this disease. Here we report DNA methylome analysis and mutation profiling of 167 JMML samples. We identify three JMML subgroups with unique molecular and clinical characteristics. The high methylation group (HM) is characterized by somatic PTPN11 mutations and poor clinical outcome. The low methylation group is enriched for somatic NRAS and CBL mutations, as well as for Noonan patients, and has a good prognosis. The intermediate methylation group (IM) shows enrichment for monosomy 7 and somatic KRAS mutations. Hypermethylation is associated with repressed chromatin, genes regulated by RAS signaling, frequent co-occurrence of RAS pathway mutations and upregulation of DNMT1 and DNMT3B, suggesting a link between activation of the DNA methylation machinery and mutational patterns in JMML

Cytopenia levels for aiding establishment of the diagnosis of Myelodysplastic Syndromes

We recommend that standard hematologic values be used to define cytopenias in MDS and believe a modification of the WHO definition of cytopenias as 1 of the criteria (in addition to definitive morphologic and/or cytogenetic findings) to diagnose MDS would be valuable and most accurate

The self and other connection: the relationship between attachment style, capacity to forgive, and defensive style

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references.Issued also on microfiche from Lange Micrographics.Working from Bartholomew's four-fold delineation of attachment styles (secure, preoccupied, dismissing, & fearful) along two attachment dimensions (self and other), this study explored the complementarity of self-and other-representations posited by Bowlby as a function of three variables: attachment style or dimension, relative maturity of defensive style, and the capacity to forgive self and other. Subjects were 206 students from the Texas A&M subject pool and included 73 males and 133 females (aged 17 to 55 years). The results suggest that the use of a particular attachment style or dimension can be related predictably, but modestly, to the individual's self-reported capacity to forgive either self or other. The pattern of relationships which resulted lent general support to the validity of Bartholomew's four-fold model of attachment with its orthogonal self and other dimensions. Analysis also revealed that, with one notable exception, the hypothesized relationship of the attachment styles or dimensions with defensive styles found modest support. As it turned out, the attachment styles with congruent self and other valences, could be related more predictably to individual defensive styles. The overall results concerning the relationship of attachment style and defensive style with university students were consistent with earlier infant and child attachment research in this area. In addition, the hypothesized relationship between the use of a particular defensive style and the capacity to forgive self or other received consistent, but moderate, validation. The predictable association of the capacity to forgive self and other with defensive styles lends support to the ethologically-grounded idea that forgiveness possesses either a survival value of its own or one lent it by its predictable association with the various defensive styles. In addition, following the lead of research on defensiveness in infant and child attachment, this present study provides empirical evidence for the presence of defensive operations in insecurely attached university students. Finally, in spite of the positive findings from this present study which indicate that the relationships between attachment style, forgiveness style, and defensive style can be predictably determined, the modest nature of the results suggests that cautious optimism is appropriate until the results have been replicated

Percutaneous Epidural Hydrogel Sealant for the Treatment of Spontaneous Intracranial Hypotension: A Case Report of Chronic Thoracic Neuralgia and Technical Lessons Learned

We report a case in which a 34-year-old female with refractory intracranial hypotension headaches due to a spontaneous dural tear was ultimately treated with CT-guided transforaminal epidural placement of a synthetic absorbable sealant (DuraSeal®). The procedure successfully resolved her headaches; however she subsequently developed thoracic neuralgia presumably due to mass effect of the sealant material on the lower thoracic spinal cord and nerve roots. This case report describes the potential for significant spinal cord and nerve root compression as well as the development of chronic neuralgia with the placement of epidural hydrogel and fibrin glue sealants. Careful consideration should be taken into the needle gauge, needle position, injectate volumes, and injection velocity when delivering the sealant to the epidural space. Use of an 18-gauge Tuohy needle with a slow but steady injection pressure, constant patient feedback, and a conservative injectate volume (less than 2 ml per level) may best optimize sealant delivery to minimize the risk of spinal cord compression and neurologic injury