Real-Time Genomic Epidemiological Evaluation of Human Campylobacter Isolates by Use of Whole-Genome Multilocus Sequence Typing

Sequence-based typing is essential for understanding the epidemiology of Campylobacter infections, a major worldwide cause of bacterial gastroenteritis. We demonstrate the practical and rapid exploitation of whole-genome sequencing to provide routine definitive characterization of Campylobacter jejuni and Campylobacter coli for clinical and public health purposes. Short-read data from 384 Campylobacter clinical isolates collected over 4 months in Oxford, United Kingdom, were assembled de novo. Contigs were deposited at the pubMLST.org/campylobacter website and automatically annotated for 1,667 loci. Typing and phylogenetic information was extracted and comparative analyses were performed for various subsets of loci, up to the level of the whole genome, using the Genome Comparator and Neighbor-net algorithms. The assembled sequences (for 379 isolates) were diverse and resembled collections from previous studies of human campylobacteriosis. Small subsets of very closely related isolates originated mainly from repeated sampling from the same patients and, in one case, likely laboratory contamination. Much of the within-patient variation occurred in phase-variable genes. Clinically and epidemiologically informative data can be extracted from whole-genome sequence data in real time with straightforward, publicly available tools. These analyses are highly scalable, are transparent, do not require closely related genome reference sequences, and provide improved resolution (i) among Campylobacter clonal complexes and (ii) between very closely related isolates. Additionally, these analyses rapidly differentiated unrelated isolates, allowing the detection of single-strain clusters. The approach is widely applicable to analyses of human bacterial pathogens in real time in clinical laboratories, with little specialist training required.     

Correction to: Quality use of diagnostic imaging in trauma,and the impact on emergency medical practice—a retrospective clinical audit

Emergency Radiology - A Correction to this paper has been published: https://doi.org/10.1007/s10140-021-01926-1     

Type D Personality is Not Associated with Coronary Heart Disease Risk in a North American Sample of Retirement-aged Adults

Background

Type D personality is associated with recurrent coronary heart disease (CHD) risk but there is limited and inconsistent evidence regarding incident risk among persons free of clinical CHD.

Purpose

We examined the association between Type D personality and coronary heart disease (CHD) risk in apparently healthy adults. We also explored the association of these traits with waist circumference, body mass index (BMI), and inhibited physician consultation behavior.

Methods

Cross-sectional study of North American retirement-aged residents (N?=?303). The primary outcome variable was a modified 10-year absolute CHD risk score from the Framingham Heart Study. Secondary outcomes included adiposity and a 5-item measure of patient/provider interaction inhibition. We regressed CHD risk on negative affect (NA), social inhibition (SI), and the NAxSI interaction (i.e., the Type D personality) and repeated these analyses for adiposity and for patient/provider interaction inhibition. We also contrasted CHD risk across Type D and non-Type D categories.

Results

None of the personality variables were associated with CHD risk for the whole sample (regression coefficients from ?0.11 to .10, Ps?>?0.29) or in gender-specific analyses. For adiposity, NA was positively associated and SI was negatively associated with BMI in women (Ps?<?0.05), but there were no other personality associations. Patient/provider interaction inhibition was associated with SI (P?<?0.001) but not NA or the NAxSI interaction (P?=?0.42). The contrast between Type D and non-Type D personality revealed no differences in CHD risk (P?=?0.93).

Conclusions

Neither Type D nor its constituent NA and SI traits were associated with absolute incident CHD risk in retirement-aged adults free of reported CHD. Optimal analytic practices and attention to patient/provider interaction behavior will improve our understanding of the association between Type D personality traits and health.     

Bone Cement Dislodgement: One of Complications Following Bone Cement Augmentation Procedures for Osteoporotic Spinal Fracture

Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient''s medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.