Pediatric blunt abdominal trauma

Blunt pediatric trauma is a major threat to the health and well-being of children. Nationwide, many practitioners care for children who face this issue. Some key principles related to the evaluation and management of these children are elucidated in this article.     

1722例已婚女性宫颈细胞中人乳头瘤病毒基因的分型

目的探讨已婚女性宫颈细胞中23种人乳头瘤病毒(HPV)感染的基因分布情况及其临床意义。方法采用基因扩增芯片技术对1 722例已婚女性的宫颈上皮细胞标本进行23种HPV基因型别的检测,并对受检者进行相关资料分析。结果 1 722例中检出HPV感染者178例,总的HPV感染率为10.34%(178/1 722),其中单一型别的阳性检出率为8.89%(153/1 722);单一型别的感染中HPV43型为27例,其阳性检出率为1.57%(27/1 722),是最主要的感染型别。混合型HPV感染25例,其阳性检出率为1.45%(25/1 722);其中HPV16型+X型7例及16型+X型+X型2例,占混合型感染的36.00%(9/25),是混合型感染的主要型别,其次是HPV43型的2型感染6例和3型感染2例,占混合型感染的32.00%(8/25)。结论 HPV43、58型单一型别及HPV16、43型的混合型是感染的主要基因型别,基因扩增芯片检测技术可应用于宫颈细胞标本,一次性可检测23种HPV基因型别,特异性强,敏感性高。     

Comparison of bone reactions to coated tricalcium phosphate and pure titanium dental implants in the canine iliac crest

Titanium and TCP-coated implants were compared after insertion in the canine iliac crest. Observation time was 14 wk. Evaluation included pull-out tests, energy dispersive X-ray analysis, and histologic examination of in situ, undemineralized implants. The TCP-coated implants were more firmly attached to bone than were the titanium implants. The calcium/phosphorus ratios around the titanium implants were higher than around the TCP-coated implants. Both types of implants were closely surrounded by bone after a 14-wk implantation.     

Late-preterm infants,early-term infants,and timing of elective deliveries; current status in a Korean medical center

Objective: The aim of this study was to examine the current perinatal outcomes among infants born late-preterm and early-term compared to those born full-term and evaluate the optimal gestational age for delivery.

Methods: We performed a retrospective cohort study for births occurred at Seoul St. Mary’s Hospital over the past 7 years. Statistical comparison was performed using χ² test and multivariable logistic regression models.

Results: A total of 7580 women met the study criteria. Compared to 39 weeks, delivery at late-preterm and early-term had higher risk of composite morbidity, including respiratory morbidities, intracranial hemorrhage (ICH), and admission to neonatal intensive care unit (NICU) (34 weeks adjusted odds ratio [aOR]: 132.54; 95% confidence interval (CI): 74.00–240.10; 37 weeks aOR: 2.14; 95%CI: 1.65–2.77). The risks of sepsis and necrotizing enterocolitis in deliveries before 36 weeks and the risk of feeding difficulty in deliveries before 37 weeks were significantly higher than those of 39 weeks. Neonatal morbidity at deliveries was not significantly different between 38 and 39 weeks.

Conclusions: Neonatal morbidities at late-preterm births are significant and surveillance for them seems increasing. Obstetricians should recognize the risk of respiratory morbidity, ICH, and NICU admission for deliveries before 38 weeks’ gestation.     

Hospital‐based influenza surveillance in Korea: Hospital‐based influenza morbidity and mortality study group

Influenza epidemics occur annually with variations in size and severity. Hospital‐based Influenza Morbidity & Mortality was established to monitor influenza epidemics and their severity, which is composed of two surveillance systems: emergency room‐based and inpatient‐based surveillance. Regarding emergency room‐based surveillance, influenza‐like illness index (influenza‐like illness cases per 1,000 emergency room‐visiting subjects), number of laboratory‐confirmed cases and the distribution of influenza types were estimated weekly. Inpatient‐based surveillance included monitoring for hospitalization, complications, and mortality. The emergency room influenza‐like illness index correlated well with the number of laboratory‐confirmed influenza cases, and showed a bimodal peak at Week 4 (179.2/1,000 emergency room visits) and Weeks 13‐14 (169.6/1,000 emergency room visits) of 2012. Influenza A was the predominant strain during the first epidemic peak, while influenza B was isolated exclusively during the second peak. In 2011–2012 season, the mean admission rate of emergency room‐visiting patients with influenza‐like illness was 16.3% without any increase over the epidemic period. Among the hospitalized patients with influenza, 33.6% (41 out of 122 patients) were accompanied by complications, and pneumonia (28.7%, 35 out of 122 patients) was the most common. Most fatal cases were caused by influenza A (96.2%) after the first epidemic peak. In conclusion, Hospital‐based Influenza Morbidity & Mortality was effective for monitoring the trends in circulating influenza activity concurrently with its severity. In the 2011–2012 season, the influenza epidemic persisted for a ≥5‐month period, with a bimodal peak of influenza A and B in sequence. Overall, influenza A was more severe than influenza B. J. Med. Virol. 85:910–917, 2013. © 2013 Wiley Periodicals, Inc.     

Evaluation of pregnancy-associated plasma protein A (PAPP-A) and free beta subunit of human chorionic gonadotropin (beta hCG) levels and sonographic assesement of fetal nuchal translucency (NT) in singleton pregnancies between 11 and 14 weeks of gestation--Polish multi-centre research

Evaluation of pregnancy-associated plasma protein A (PAPP-A) and free beta subunit of human chorionic gonadotropin (beta hCG) levels and sonographic assessment of fetal nuchal translucency (NT) in singleton pregnancies between 11 and 14 weeks of gestation--Poland's multi-centers research. OBJECTIVES: Pregnancy-associated plasma protein A has been reported to be low in Down syndrome affected pregnancies during the first trimester of pregnancy. Enlarged nuchal translucency (NT) is observed in about 80% of fetuses affected with chromosomal abnormalities and congenital heart defects (CHD). MATERIAL AND METHODS: The aim of this study were to determine value and the medians of free beta-human chorionic gonadotropin (beta-hCG) and pregnancy associated plasma protein-A (PAPP-A) and nuchal translucency thickness in the first trimester in a prospective study of a non-selected Polish population. RESULTS: All examinations have been performed according to the Fetal Medicine Foundation (FMF) rules. We have included 800 women between 11 weeks 0 days and 13 weeks 6 days gestation into a biochemical examination. Women booked into the clinic were offered screening, using a combination of maternal serum free beta-hCG and pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal translucency thickness. The maternal serum were measured using the Kryptor analyzer (Brahms Diagnostica). All pregnant women have been divided into 2 groups younger than (first group) and older than (second group) 35 years of age. CONCLUSIONS: Nomogrames for free beta-hCG and PAPP-A levels in physiological pregnancy between 11(+0) and 13(6) weeks were determined in the examined population. A positive correlation between PAPP-A and CRL levels, as well as a weak negative correlation between free beta-hCG and CRL, were demonstrated.