主、肺动脉的超声观测诊断胎儿心脏大血管畸形的研究

目的 探讨主、肺动脉的超声观测作为产前筛选胎儿心脏大血管畸形主要线索的诊断价值。方法 对100例20～40周正常孕妇采用超声心动图测量主、肺动脉内径，并计算肺动脉内径和主动脉内径比值(PA／AO)。按照PA／AO的正常比值对2683例20周以上孕妇进行胎儿先天性心脏病(CHD)筛选。结果 （1）不同孕龄的胎儿其PA、AO内径随孕龄增加而增大，但是其PA／AO比值相对较为恒定，约为1．0～1．2。(2)多种胎儿心脏大血管畸形包括主动脉弓发育不良、主动脉狭窄、肺动脉狭窄、法乐氏四联征、主动脉缩窄等，其PA／AO比值明显异常。结论 胎儿PA／AO作为产前筛选胎儿CHD指标，尤其是胎儿大血管畸形，是一项实用的指标。     

Mechanisms and possible controls of the in utero Zika virus infection: Where is the Holy Grail?

Zika virus infection (ZVI) is a great concern for human health because it frequently causes fetal anomalies. Little is known about pathophysiology of ZVI because it has been regarded as a mild, no life‐threatening infection. However, the latest endemic in South and Central America took attention of perinatologists, microbiologists, and pathologists. Both in vivo and in vitro studies suggest neurotropic nature of Zika virus but do not clarify viral kinetics during vertical transmissions. In this review, we focus on the clinical and microbiological natures ZVI for pregnant women especially how placental barriers are broken down.     

Zika: An Unfolding Story

In our previous article on Zika, we established that it is a member of the Flaviviridae virus family. In this article, we discuss updated information regarding transmission and complications of Zika. In addition to contracting Zika virus from an infected mosquito, it has been transmitted between mother and fetus/infant and between sexual partners. Zika has been associated with Guillain-Barré syndrome, although the causal link has yet to be established. Microcephaly is a primary concern for fetuses of pregnant women infected with Zika virus. The most effective prevention strategy is to avoid mosquito bites in high-risk Zika areas.     

Bad news: Families’ experiences and feelings surrounding the diagnosis of Zika‐related microcephaly

The rapidly increasing number of cases of Zika virus and limited understanding of its congenital sequelae (e.g., microcephaly) led to stories of fear and uncertainty across social media and other mass communication networks. In this study, we used techniques generic to netnography, a form of ethnography, using Internet‐based computer‐mediated communications as a source of data to understand the experience and perceptions of families with infants diagnosed with Zika‐related microcephaly. We screened 27 YouTube? videos published online between October 2015 and July 2016, during which the Zika epidemic started, peaked, and declined. We identified three themes: (a) experiencing the news of a diagnosis of Zika‐associated microcephaly; (b) experiencing feelings and expectations of the ‘imperfect’ child; and (c) seeking to understand microcephaly to care for the child. We found that families experienced distressing feelings of shock, sadness, hopelessness, and pain, while dealing with emerging and sometimes conflicting information being transmitted by news outlets, uncertainty about the child's health, and healthcare providers’ lack of clarity to guide the family members. The ‘unknown’ factor of ZIKA was an additional stressful factor in the experience of the families.     

Zika Virus and Zika Virus Disease

During recent months, there has been growing international public concern about the Zika virus. As scientific understanding of the Zika virus unfolds, there are still many unanswered questions. Public health officials, clinicians, and consumers alike have questions about the Zika virus and the Zika virus disease. There is a need to know where to turn for the most up-to-date and reliable online information sources. Although aspects of Zika virus disease and associated medical conditions can be frightening, information seekers may find reassurance in the following online sources to guide their understanding of risk, prevention, transmission, affected geographical areas, symptoms, and disease management.     

Neurological complications of Zika virus infection

Introduction: Zika virus (ZIKV) disease is a vector-borne infectious disease transmitted by Aedes mosquitoes. Recently, ZIKV has caused outbreaks in most American countries.

Areas covered: Publications about neurological complications of ZIKV infection retrieved from pubmed searchers were reviewed, and reference lists and relevant articles from review articles were also examined. Vertical/intrauterine transmission leads to congenital infection and causes microcephaly and congenital ZIKV syndrome. ZIKV preferentially infects human neural progenitor cells and triggers cell apoptosis. ZIKV RNA has been identified in foetal brain tissue and brains of microcephalic infants who died; amniotic fluid and placentas of pregnant mothers; and umbilical cord, cerebro-spinal fluid and meninges of newborns. The increase in the number of Guillain-Barre syndrome (GBS) cases during the ZIKV outbreak in the Americas provides epidemiological evidence for the link between ZIKV infection and GBS. Less frequently reported ZIKV neurological complications include encephalitis/meningoencephalitis, acute disseminated encephalomyelitis, myelitis, cerebrovascular complications (ischemic infarction; vasculopathy), seizures and encephalopathy, sensory polyneuropathy and sensory neuronopathy. Analysis of GBS incidence could serve as an epidemiological ‘marker’ or sentinel for ZIKV disease and other neurological complications associated to ZIKV.

Expert commentary: An expanding spectrum of neurological complications associated with ZIKV infection is being recognised.